Objective: To evaluate patient-centered outcomes after deep brain stimulation in Parkinson’s disease.

Background: Deep brain stimulation (DBS) is an effective treatment for Parkinson’s disease (PD) patients. Long-term outcomes have demonstrated sustained improvement in motor symptoms. However, few studies have evaluated patient-centered outcomes (PCO).

Method: A PCO questionnaire was administered to PD patients post-DBS. It measured outcomes on mobility, gait, postural instability, cognitive, speaking and psychiatric symptoms, sexual functions, pain, social life, and issues related to the DBS device. All questions were scored on a five-point Likert scale, where 4 and 5 points were the most favorable outcomes. Demographic data and Hoehn & Yahr scale (H&Y) before surgery was collected. Data on DBS therapy included the stimulation target and electric parameters.

Results: Forty-seven patients answered the questionnaire (55.3% males). Mean age was 58.3y (SD 8.7). Mean H&Y stage was 3.3 (SD 0.6), and mean DBS therapy duration was 25.5 months. Subthalamic nucleus (STN) was the target in 38 (80.8%), and Forel’s field in 9 patients. Mean amplitude, frequency and pulse-width were 2.7 V, 158 Hz and 64.5 ms. Mobility: 89.4% of patients agreed that DBS improved walk velocity in small distances (100 m), and 80.9% agreed that DBS facilitated walk (1 km). Postural instability: 85.1% of patients agreed they have better balance and 76.6% agreed they have less falls. Pain was reduced in 68.1% of patients, and sexual performance was better for 42.6%. Anxiety was reduced for 72.3% of patients, whereas depression was reduced for 80.8%. Most patients (80.6%) agreed they feel better during social activities. On the other hand, 42.6% experienced worsening of speaking, and 23.4% referred worse episodic memory. DBS device was not a problem for 85.1%. There was a non-significant trend towards lower grades in patients who had Forel’s field surgical target (mean score 162.9) compared to STN (mean score 183.3). A multivariable regression analysis showed younger age as a predictive factor for good outcomes after DBS surgery. Overall mean grade (0 to 10) for patient satisfaction with DBS therapy was 8.9, and 96.7% would undergo the surgical treatment again

Conclusion: After an average of 2 years post-DBS surgery, the majority of patients were satisfied, felt they had made the correct decision to undergo DBS and would choose to have DBS again.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/patient-centered-outcomes-of-deep-brain-stimulation-in-parkinsons-disease/