The probable REM sleep behavior disorder negatively affects health-related quality of life in Parkinson's disease with bilateral subthalamic nucleus stimulation

Objective: The aim of this study was to compare the shortand long-term outcomes of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) patients with and without probable REM sleep behavior disorder (RBD). Methods: We retrospectively reviewed 127 patients who underwent bilateral STN-DBS for PD with probable RBD from September 2011 to November 2018. Motor performance, physical and mental health-related quality of life (HRQoL), cognitive function, and depressive severity were compared between with or without probable RBD at the baseline and at the 1-, 3- or 5-year follow-up. Results: One hundred three PD patients (55 with RBD; 48 without RBD) were evaluated at the baseline and at the 1-year follow-up and 33 (17 with RBD, 16 without RBD) of them were examined at the 5-year follow-up. Motor performances were significantly improved in the non-RBD group compared to the RBD group at the 1-year follow-up, and there was a trend toward a greater difference in the physical HRQoL compared with the 1-year follow-up. There were also marked improvements of axial symptom and physical HRQoL in the non-RBD group compared with the RBD group from baseline to 5 years after STN-DBS. Conclusion: Our study showed that RBD negatively affected the shortand long-term outcomes on motor performances, especially axial symptom and HRQoL after STN-DBS in PD patients.