Deep brain stimulation and responsiveness of the Persian version of Parkinson's disease questionnaire with 39-items.

  • Gholam Ali Shahidi Department of Neurology, School of Medicine, Rasoule-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
  • Zeinab Ghaempanah Department of Psychology, School of Humanities, Tarbiat-Modares University, Tehran, Iran.
  • Yasaman Khalili Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • Marzieh Nojomi Department of Community Medicine, School of Medicine, Preventive Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.
Keywords: Deep Brain Stimulation, Parkinson’s Disease Questionnaire with 39-Items, Responsiveness


Background:  Assessment  of quality-of-life (QOF) as  an outcome   measure   after  deep   brain  stimulation   (DBS) surgery in patients  with Parkinson’s disease  (PD) need  a valid, reliable and responsive  instrument. The aim of the current   study   was   to   determine   responsiveness   of validated  Persian  version  of PD questionnaire  with  39- items (PDQ-39) after DBS surgery in patients with PD.
Methods: Eleven patients with PD, who were candidate  for DBS  operation  between May 2012 and  June  2013 were assessed.  PDQ-39 and  short-form  questionnaire  with 36- items (SF-36) were used. To assess responsiveness of PDQ- 39 standardized response mean (SRM) was used.
Results: Mean age was 51.8 (8.8) and all of the patients, but just  one  were  male  (10 patients). Mean duration  of the disease was 8.7 (2.1) years. Eight patients  were categorized as moderate using Hoehn and Yahr (H and Y) classification. All patients  had a better  H and Y score compared  with the baseline evaluation (3.09 vs. 0.7 ). The amount  of SRM was above  0.70 for all domains  means  a large responsiveness for PDQ-39.
Conclusion: Persian version of PDQ-39 has an acceptable responsiveness and could be used to assess as an outcome measure to evaluate the effect of therapies on PD.


1. de Rijk MC, Launer LJ, Berger K, Breteler MM, Dartigues JF, Baldereschi M, et al. Prevalence of Parkinson's disease in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology 2000; 54(11 Suppl 5): S21-S23.
2. Schrag A. Quality of life and depression in Parkinson's disease. J Neurol Sci 2006; 248(1-2): 151-7.
3. Kuopio AM, Marttila RJ, Helenius H, Toivonen M, Rinne UK. The quality of life in Parkinson's disease. Mov Disord 2000; 15(2): 216-23.
4. Martinez-Martin P, Valldeoriola F, Tolosa E, Pilleri M, Molinuevo JL, Rumia J, et al. Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson's disease. Mov Disord 2002; 17(2): 372-7.
5. Limousin P, Krack P, Pollak P, Benazzouz A, Ardouin C, Hoffmann D, et al. Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease. N Engl J Med 1998; 339(16): 1105-11.
6. Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus pallidus in Parkinson's disease. N Engl J Med 2001; 345(13): 956-63.
7. Smeding HM, Speelman JD, Huizenga HM, Schuurman PR, Schmand B. Predictors of cognitive and psychosocial outcome after STN DBS in Parkinson's Disease. J Neurol Neurosurg Psychiatry 2011; 82(7): 754-60.
8. Rodriguez-Oroz MC, Zamarbide I, Guridi J, Palmero MR, Obeso JA. Efficacy of deep brain stimulation of the subthalamic nucleus in Parkinson's disease 4 years after surgery: double blind and open label evaluation. J Neurol Neurosurg Psychiatry 2004; 75(10): 1382-5.
9. Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schafer H, Botzel K, et al. A randomized trial of deep-brain stimulation for Parkinson's disease. N Engl J Med 2006; 355(9): 896-908.
10.Weaver FM, Follett K, Stern M, Hur K, Harris C, Marks WJ, Jr., et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA 2009; 301(1): 63-73.
11.Williams A, Gill S, Varma T, Jenkinson C, Quinn N, Mitchell R, et al. Deep brain stimulation plus best medical therapy versus best medical therapy alone for advanced Parkinson's disease (PD SURG trial): a randomised, open-label trial. Lancet Neurol 2010; 9(6): 581-91.
12.Okun MS, Fernandez HH, Wu SS, Kirsch- Darrow L, Bowers D, Bova F, et al. Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: the COMPARE trial. Ann Neurol 2009; 65(5): 586-95.
13.Jenkinson C, Peto V, Fitzpatrick R, Greenhall R, Hyman N. Self-reported functioning and well-being in patients with Parkinson's disease: comparison of the short-form health survey (SF-36) and the Parkinson's Disease Questionnaire (PDQ- 39). Age Ageing 1995; 24(6): 505-9.
14.Peto V, Jenkinson C, Fitzpatrick R, Greenhall R. The development and validation of a short measure of functioning and well being for individuals with Parkinson's disease. Qual Life Res 1995; 4(3): 241-8.
15.Grove A, Grey Amante P, Quarterman P, Wild D. The translation and cross-cultural adaptation of quality-of-life measures. In: Jenkinson C, Fitzpatrick R, Jenkinson D, editors. Health Status Measurement in Neurological Disorders. Oxford, UK: Radcliffe Publishing; 2000. p. 161-90.
16.Nojomi M, Mostafavian Z, Shahidi GA, Jenkinson C. Quality of life in patients with Parkinson's disease: Translation and psychometric evaluation of the Iranian version of PDQ-39. J Res Med Sci 2010; 15(2): 63-9.
17.Deyo RA, Diehr P, Patrick DL. Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. Control Clin Trials 1991; 12(4 Suppl): 142S-58S.
18.Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry 1988; 51(6): 745-52.
19.Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 2005; 14(3): 875-82.
20.Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967; 17(5): 427-42.
21.Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol 2000; 53(5): 459-68.
22.Muangpaisan W, Hori H, Brayne C. Systematic review of the prevalence and incidence of Parkinson's disease in Asia. J Epidemiol 2009; 19(6): 281-93.
23.Nyholm D, Nilsson Remahl AI, Dizdar N, Constantinescu R, Holmberg B, Jansson R, et al. Duodenal levodopa infusion monotherapy vs oral polypharmacy in advanced Parkinson disease. Neurology 2005; 64(2): 216-23.
24.Fitzpatrick R, Peto V, Jenkinson C, Greenhall R, Hyman N. Health-related quality of life in Parkinson's disease: a study of outpatient clinic attenders. Mov Disord 1997; 12(6): 916-22.
25.Harrison JE, Preston S, Blunt SB. Measuring symptom change in patients with Parkinson's disease. Age Ageing 2000; 29(1): 41-5.
26.Chen SY, Lo SF, Tsai ST. A systematic review of the impact of subthalamic nucleus stimulation on the quality of life of patients with Parkinson's disease. Tzu Chi Medical Journal 2014; 26(1): 15-20.
How to Cite
Shahidi GA, Ghaempanah Z, Khalili Y, Nojomi M. Deep brain stimulation and responsiveness of the Persian version of Parkinson’s disease questionnaire with 39-items. Iran J Neurol. 13(4):220-225.
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