Objective: To describe the clinical outcomes in PD patients following DBS and analyse whether certain demographic and clinical factors are associated with poor outcomes.

Background: Deep Brain Stimulation (DBS) has become an established treatment for patients with Parkinson’s Disease (PD) and significant motor fluctuations. We discuss outcomes following DBS insertion at our centre over a 7-year period.

Method: 50 PD patients (mean age at surgery 59.3 years, 32 male, 18 female) had DBS implanted between 2015-2022 at our centre. We recorded their baseline factors including demographics, levodopa equivalent daily dosage (LEDD) and modified Rankin Score (mRS). The outcomes measured 1-year after DBS and most recent DBS clinic visit (mean 1,613 days after DBS) were dementia diagnosis, residential/nursing home (NH) admission, mRS and death. Statistical tests were performed using SPSS Version 28.

Results: Average baseline OFF UPDRS motor score was 48 and mean disease duration at surgery was 13.1 years. Average LEDD fell >25% from baseline to 1-year after DBS (765mg to 564mg, p = 0.001). Average mRS was unchanged from baseline to 1-year after DBS (mRS 2.1 to 2.3, p = 0.204), but was significantly worse by most recent clinic visit (mRS 2.9, p<0.001). Average total electrical energy delivered (TEED) was unchanged during the follow-up period (p = 0.220).

The following outcomes occurred (time measured as mean days since DBS): 11 developed dementia (1,141 days, range 180-2379), 9 admitted to residential/NH (1,184 days, range 39-2384) and 6 patients died (1,518 days, range 982-2175). Smoking was associated with residential/NH admission (p = 0.008) and female gender was associated with increased mortality (p = 0.010) by the most recent clinic visit. There was no association between baseline LEDD, baseline OFF UPDRS motor scores, or having English as a second language with poor outcomes following DBS.

The main limitations are the lack of a comparator group, small sample size and retrospective data collection.

Conclusion: Our DBS patient selection appears appropriate, as most patients remained functionally independent (mRS 2.9) over 4 years after DBS. mRS was unchanged from baseline to 1-year after DBS but had worsened by most recent visit; this likely represents PD progression given outcome latency. Smoking was associated with NH admission and female gender associated with increased mortality following DBS.

References: n/a

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-in-parkinsons-disease-real-world-outcomes-at-a-single-centre/