Objective: To evaluate satisfaction level and quality of life in Mexican PD patients after undergoing deep brain stimulation surgery using a structured questionnaire assessimg motor and non-motor symptoms.

Background: Parkinson’s disease (PD) is a degenerative and progressive neurological disorder characterized by considerable heterogeneity in onset, expression and progression of symptoms [1,2]. Over the past 25 years, the use of deep brain stimulation (DBS) has become one of the most important therapies for refractory motor circuit disorders, offering an advantage in the capacity of change stimulation parameters [3,4]. Nearly half of patients with PD develop stimulation-resistant symptoms, such as motor (gait and postural instability) and non-motor deficits [5], a phenomenon described as “habituation”, being the process of accepting the long-term benefits of the DBS, which fades over time [6]. While it is generally accepted, these findings have not been considered, hence, the importance of patient satisfaction and expectations is underestimated.

Method: A retrospective longitudinal study of PD patients who underwent DBS surgery was carried out. As a result, a follow-up from the time of surgery to the current date (3.75 ± 2 years) was performed. Scales were applied for motor (MDS-UPDRS) and non-motors symptoms (NMSS), and quality of life (PDQ-8) before and after surgery. A satisfaction questionnaire was performed in the postoperative period. Wilcoxon rank test was used to prove significant differences and Spearman’s test was used to analyze correlations.

Results: 20 Mexican PD DBS surgery patients were included (55% male and 45% female; 55.7 ± 14.12 years-old). Mean duration of the disease prior to surgery was 10.37 ± 8.4 years. Most patients ( 85.5%) reported that the surgery met their expectations  (half visual analog scale score 0 to 100)  and 92% were satisfied. Satisfaction was correlated with patient expectations, but did not correlate with quantitative changes in PDQ-8, NMSS, and MDS-UPDRS scores in the preoperative and postoperative period..

Conclusion: Patients were highly satisfied with DBS. Therefore, the management of expectations before and after surgery plays an essential role in the level of satisfaction of Mexican patients living with PD disease.

References: [1] Poortvliet PC, Gluch A, Silburn PA, et al. The Queensland Parkinson’s Project: An Overview of 20 Years of Mortality from Parkinson’s Disease. Journal of movement disorders. 2021;14(1):34–41. https://doi.org/10.14802/jmd.20034.
[2] Van Den Eeden SK, Tanner CM, Bernstein AL, et al. Incidence of Parkinson’s Disease: variation by age, gender, and race/ethnicity. Am J Epidemiol. 2003;157:1015-22.
[3] Lozano AM, Lipsman N, Bergman H, et al. Deep brain stimulation: current challenges and future directions. Nat Rev Neurol. 2019;15:148–160.
https://doi.org/10.1038/s41582-018-0128-2.
[4] Schuepbach WM, Michael, Tonder, et al. Quality of life predicts outcome of deep brain stimulation in early Parkinson disease. Neurology. 2019.
doi:10.1212/WNL.0000000000007037.
[5] Artusi CA, Dwivedi AK Romagnolo A, et al. Association of Subthalamic Deep Brain Stimulation With Motor, Functional, and Pharmacologic Outcomes in Patients With Monogenic Parkinson Disease. JAMA Network Open. 2019;2(2):e187800–. doi:10.1001/jamanetworkopen.2018.7800.
[6] Peters J, Tisch S. Habituation After Deep Brain Stimulation in Tremor Syndromes: Prevalence, Risk Factors and Long-Term Outcomes. Frontiers in Neurology. 2021;12. doi=10.3389/fneur.2021.696950.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/satisfaction-level-quality-of-life-motor-and-non-motor-symptoms-outcomes-of-mexican-pd-patients-after-deep-brain-stimulation/