Is being asymmetric a bad thing? Insights from a longitudinal observational study on STN-DBS Parkinson's disease
Abstract
Background: Motor asymmetry is a characteristic feature of Parkinson's disease (PD); however, its definition and long-term evolution and clinical implications remain unclear.Objectives: Assess the trajectory of motor asymmetry at 3 and 5 years post-STN-DBS, as well as its impact on axial symptoms and quality of life (QoL).Methods: Utilizing data from the PREDISTIM cohort, which includes over 500 patients and is representative of a large advanced PD population, we analyzed motor asymmetry (defined as the difference between right and left appendicular motor scores) at 1, 3, and 5 years following STN-DBS. Absolute and normalized (normalization based on global motor severity) asymmetry were quantified using MDS-UPDRS III scores in the Stim ON/Med ON state. Axial symptoms and QoL were assessed using the axial subscore and PDQ-39, respectively. Statistical analyses included mediation models to explore the interplay between asymmetry, motor severity, and clinical outcomes.Results: Normalized motor asymmetry decreased over time, despite an increase in absolute asymmetry and overall motor severity. Higher normalized asymmetry was associated with lower axial scores and better QoL. Mediation analyses confirmed that the relationship between motor asymmetry, axial scores, and QoL was largely associated with overall motor severity.Conclusions: These findings suggest that a higher normalized motor asymmetry in advanced PD stage reflects an appendicular phenotype, which is associated with better QoL. Its reduction over time corresponds to increased axial involvement.
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BibTeX
@article{barbosa2026being,
title = {{Is being asymmetric a bad thing? Insights from a longitudinal observational study on STN-DBS Parkinson's disease}},
author = {Raquel Pinheiro Barbosa and Paulo Bastos and Matthieu Béreau and Anne Sophie Rolland and Olivier Rascol and Christine Brefel-Courbon and Fabienne Ory Magne and Amaury de Barros and Caroline Moreau and Elodie Hainque and Tiphaine Rouaud and Ana Marques and Alexandre Eusebio and Olivier Colin and Sophie Drapier and Dominique Guehl and David Maltête and Christine Tranchant and Caroline Giordana and Melissa Tir and Stéphane Thobois and Lucie Hopes and Jean-Philippe Brandel and Béchir Jarraya and Jean-Christophe Corvol and David Devos and Margherita Fabbri},
journal = {Parkinsonism \& Related Disorders},
year = {2026},
month = sep,
doi = {10.1016/j.parkreldis.2026.108283},
url = {https://hal.science/hal-05574088v1},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Is being asymmetric a bad thing? Insights from a longitudinal observational study on STN-DBS Parkinson's disease
AU - Raquel Pinheiro Barbosa
AU - Paulo Bastos
AU - Matthieu Béreau
AU - Anne Sophie Rolland
AU - Olivier Rascol
AU - Christine Brefel-Courbon
AU - Fabienne Ory Magne
AU - Amaury de Barros
AU - Caroline Moreau
AU - Elodie Hainque
AU - Tiphaine Rouaud
AU - Ana Marques
AU - Alexandre Eusebio
AU - Olivier Colin
AU - Sophie Drapier
AU - Dominique Guehl
AU - David Maltête
AU - Christine Tranchant
AU - Caroline Giordana
AU - Melissa Tir
AU - Stéphane Thobois
AU - Lucie Hopes
AU - Jean-Philippe Brandel
AU - Béchir Jarraya
AU - Jean-Christophe Corvol
AU - David Devos
AU - Margherita Fabbri
PY - 2026
DA - 2026/09/01
JO - Parkinsonism & Related Disorders
DO - 10.1016/j.parkreldis.2026.108283
UR - https://hal.science/hal-05574088v1
AB - Background: Motor asymmetry is a characteristic feature of Parkinson's disease (PD); however, its definition and long-term evolution and clinical implications remain unclear.Objectives: Assess the trajectory of motor asymmetry at 3 and 5 years post-STN-DBS, as well as its impact on axial symptoms and quality of life (QoL).Methods: Utilizing data from the PREDISTIM cohort, which includes over 500 patients and is representative of a large advanced PD population, we analyzed motor asymmetry (defined as the difference between right and left appendicular motor scores) at 1, 3, and 5 years following STN-DBS. Absolute and normalized (normalization based on global motor severity) asymmetry were quantified using MDS-UPDRS III scores in the Stim ON/Med ON state. Axial symptoms and QoL were assessed using the axial subscore and PDQ-39, respectively. Statistical analyses included mediation models to explore the interplay between asymmetry, motor severity, and clinical outcomes.Results: Normalized motor asymmetry decreased over time, despite an increase in absolute asymmetry and overall motor severity. Higher normalized asymmetry was associated with lower axial scores and better QoL. Mediation analyses confirmed that the relationship between motor asymmetry, axial scores, and QoL was largely associated with overall motor severity.Conclusions: These findings suggest that a higher normalized motor asymmetry in advanced PD stage reflects an appendicular phenotype, which is associated with better QoL. Its reduction over time corresponds to increased axial involvement.
SN - 1353-8020
SN - 1873-5126
ER -