Analysis of DBS Outcome by MDS-UPDRS Severity Levels: Comparison with Changes on MDS-UPDRS III

Abstract

Background: MDS-UPDRS Severity Levels (SLs), derived from clinician- and patient-rated scales, remain underused to evaluate response to subthalamic deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD).

Objectives: To evaluate MDS-UPDRS SL as markers of STN-DBS response.

Methods: SLs were categorized as mild, moderate, or severe using established cut-off points for Parts II, III Off, and IV. Improvement was defined as a decrease in at least one SL. Part III Off improvement was correlated to quality-of-life scales and used to predict SL improvement using ROC Curve analysis.

Results: A total of 51 patients (34.1% female, aged 58.9 ± 10.2 years, disease duration 12.3 ± 4.1 years) were evaluated 12 months after surgery. MDS-UPDRS III Off changes over 30% predicted SL improvements in MDS-UPDRS II (AUC = 0.83, p = 0.015) and IV (AUC = 0.89, p = 0.001).

Conclusion: Our findings suggest that improvement in MDS-UPDRS SL are potential markers of STN-DBS response. With an MDS-UPDRS part III improvement around 30% predicting SL improvement.