Predicting motor outcome and quality of life after subthalamic deep brain stimulation for Parkinson's disease: the role of standard screening measures and wearable data

Background:Standardized screening for subthalamic deep brain stimulation (STN DBS) in Parkinson’s disease (PD) patients is crucial to determine eligibility, but its utility to predict postoperative outcomes in eligible patients is inconclusive. It is unknown whether wearable data can contribute to this aim.Objective:To evaluate the utility of universal components incorporated in the DBS screening, complemented by a wearable sensor, to predict motor outcomes and Quality of life (QoL) one year after STN DBS surgery.Methods:Consecutive patients were included in the OPTIMIST cohort study from two DBS centers. Standardized assessments included a preoperative Levodopa Challenge Test (LCT), and questionnaires on QoL and non-motor symptoms including cognition, psychiatric symptoms, impulsiveness, autonomic symptoms, and sleeping problems. Moreover, an ambulatory wearable sensor (Parkinson Kinetigraph (PKG)) was used. Postoperative assessments were similar and also included a Stimulation Challenge Test to determine DBS effects on motor function.Results:Eighty-three patients were included (median (interquartile range) age 63 (56–68) years, 36% female). Med-OFF (Stim-OFF) motor severity deteriorated indicating disease progression, but patients significantly improved in terms of Med-ON (Stim-ON) motor function, motor fluctuations, QoL, and most non-motor domains. Motor outcomes were not predicted by preoperative tests, including covariates of either LCT or PKG. Postoperative QoL was predicted by better preoperative QoL, lower age, and more preoperative impulsiveness scores in multivariate models.Conclusion:Data from the DBS screening including wearable data do not predict postoperative motor outcome at one year. Post-DBS QoL appears primarily driven by non-motor symptoms, rather than by motor improvement.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Radiation induced vascular disease and ischemic stroke.

Contains fulltext : 74396.pdf (publisher's version ) (Open Access)RU Radboud Universiteit Nijmegen, 22 april 2009Promotores : Padberg, G.W.A.M., Bartelink, G.M.M. Co-promotores : Boogerd, W., Kappelle, A.C.155 p

Stroke as a late treatment effect of Hodgkin's disease.

Contains fulltext : 49694.pdf (publisher's version ) (Closed access

[From psychiatric symptoms to paraneoplastic syndrome]

Contains fulltext : 69299.pdf (publisher's version ) (Open Access)Two patients, a 38-year-old man and a 32-year-old woman, were admitted to a psychiatric ward. The first patient suffered from a mood disorder, personality changes and complained of several, hitherto unexplained physical symptoms. Finally the patient was diagnosed with paraneoplastic cerebellar degeneration associated with Hodgkin's disease. The second patient presented with psychosis and panic disorders, but the condition was later found to be caused by paraneoplastic limbic encephalitis due to ovarian teratomas. These cases illustrate that patients with paraneoplastic neurological syndromes may present with psychiatric symptoms which can hamper an early diagnosis

Progressive Muscle Atrophy and Weakness After Treatment by Mantle Field Radiotherapy in Patients with Hodgkin'S Lymphoma

Contains fulltext : 81858.pdf (publisher's version ) (Open Access

DECO1013:Assignment 2:Data Sonification <Facebook Penetration in US Colleges>

This project sonifies the penetration of Facebook in colleges in the USA. It compares the number of registered Facebook users over the years to the number of US colleges not represented on Facebook