Neuropsychiatric Disease and Treatment (Dec 2021)
Effect of Deep Brain Stimulation on Female Parkinsonian Patients with Lower Urinary Tract Symptoms
Abstract
Fuchao Liang,1,2,* Yueqing Tang,1,3,* Kaipeng Bi,1,2 Xuchen Liu,2 Chao Li,4,5 Si Chen,6 Chao Zhang,4,5 Lei Yan,1 Zhonghua Xu,1 Ning Yang4,5,7 1Department of Urology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China; 2School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 3Department of Andrology, Shandong University, Jinan, People’s Republic of China; 4Department of Neurosurgery, Qilu Hospital of Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, People’s Republic of China; 5Shandong Key Laboratory of Brain Function Remodeling, Jinan, 250012, People’s Republic of China; 6Department of Neurology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China; 7Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, 250012, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ning YangDepartment of Neurosurgery, Qilu Hospital of Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, People’s Republic of ChinaTel/Fax +86 531-82166631Email [email protected] XuDepartment of Urology, Qilu Hospital of Shandong University, Jinan, People’s Republic of ChinaTel/Fax +86 531-82166701Email [email protected]: This study aimed to investigate the characteristics of urodynamics in female parkinsonian patients with lower urinary tract symptoms (LUTS) and evaluate the outcomes of deep brain stimulation (DBS) based on overactive bladder (OAB) scores and quality of life (QOL) scores.Patients and Methods: Urodynamic assessment was performed in 20 female parkinsonian patients with LUTS. OAB scores and QOL scores were collected before and 6 months after DBS treatment (The target of DBS is STN). We evaluated the related factors affecting QOL score and also the changes in QOL score after DBS treatment.Results: The mean age of 20 patients was 60.6± 6.3 years, with 65% of patients identified with OAB in urodynamic studies. The mean OAB total score and QOL score at baseline were 7.3± 3.7 and 5.0± 1.1, respectively. Four items in the OAB score were found to be independent factors and they influenced the baseline QOL scores. Six months after DBS treatment, the OAB total score and the QOL score were significantly decreased (3.7± 3.2 (p = 0.002) and 3.4± 1.4 (p < 0.001), respectively). Improvements in OAB item 2 (nocturia) and item 3 (urgency) scores were found to be independent factors, which had an influence on the improvement in QOL scores from multivariate analysis. Improvement of OAB item 2 (nocturia) exhibited the greatest influence on improvement in the QOL score. After DBS treatment, 40% of the patients showed significant improvement in urination symptoms (≥ 2 points reduction in QOL score), 30% of the patients showed mild improvement (1 point reduction in QOL score), and 30% patients showed no improvement (no change in QOL score). No patients exhibited worsening urination symptoms.Conclusion: Most parkinsonian female patients with lower urinary tract symptoms were diagnosed with OAB. DBS treatment improved OAB symptoms. Improvement of nocturia and urgency positively impacts the QOL of female parkinsonian patients.Keywords: Parkinson’s disease, urodynamics, OAB score, QOL score
