Objective: This research is a quantitative, exploratory study, which aims to identify the symptoms that patients expect to improve with Deep brain stimulation (DBS) and whether the expected levels of improvement are met after DBS.

Background: DBS is an effective surgical treatment that improves patient quality of life in advanced PD. The perceived outcome is influenced by patients’ varying expectations on how DBS can improve their symptoms after DBS.

Methods: 28 participants with advanced PD completed a visual analogue scale (VAS) questionnaire designed to capture patient’s expectations prior to surgery and at 6 months to 2 years post DBS. 20 patients had STN-DBS and 8 had GPi-DBS.

Results: Clinical improvements were found on the UPDRS-III OFF (p 0.001), mobility (p 0.0048), ADL (p 0.008) and stigma (p 0.014) after DBS. For the STN-DBS group, there was a significant reduction in total Levodopa Equivalent Daily Doses (mg/day) by 50.45%. These objective outcomes were mirrored in the patients’ perceived improvements after DBS. There was no significant difference (two-tailed p value 0.875) between the pre-DBS expectations of general improvement in PD symptoms and the perceived general improvement 6 months to 2 years after surgery confirming that general expectations of improvement were met after DBS. Most patients reported that expectations of improvement after DBS were met: 64% for motor symptoms, 71% and 83% for QoL and reductions in medication daily dose (respectively). Only 25% of the expected levels of improvement were met for the non- motor symptoms and social domain. The motivations for DBS were also satisfied after the surgery: in the GPi-DBS group, 100% were satisfied for reduction of dyskinesias, 83.3% for motor symptoms and 66.70% for QoL. STN-DBS patients were satisfied with the reduction in medication (84.20%), 78.90% for motor symptoms and 73.70% for QoL.

Conclusions: DBS did meet the perceived expected level of improvement in motor symptoms, QoL, and reduction in medication within 6 months to 2 years after DBS surgery for the majority of patients which corresponded to the objective clinical outcome. The pre-DBS expected improvement of non-motor symptoms and social domain were not met after surgery. Overall, both STN-DBS and GPi-DBS patients were satisfied that DBS had met their expectations of surgery.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/does-the-degree-of-improvement-after-deep-brain-stimulation-surgery-for-parkinsons-disease-pd-meet-the-patients-expectations/