Session Information
Date: Monday, June 20, 2016
Session Title: Surgical therapy: Parkinson's disease
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To determine long-term patient-centered outcomes after bilateral STN DBS in PD.
Background: STN DBS is effective for motor symptoms of PD but long-term patient-centered outcomes are lacking.
Methods: We administered a survey to patients >5 years post-DBS, questioning expectations, willingness to hypothetically undergo DBS again, timing of DBS, and confidence in recommending DBS. Also, patients rated the severity of their symptoms pre-DBS and current time. All questions were scored from 0-10, whereby 0 represented the most ‘positive’ answer. Pre-operative PDQ-39, UPDRS-I, UPDRS-II, UPDRS-IV, S&E scales were repeated at time of survey.
Results: 52 patients (mean 8.2±2.6 years post-DBS) were included. Satisfaction was high with median score (range) of 1/10 (0-8) at time of survey. Pre-operative expectations were high, 2/10 (0-10), but met in 75% of patients. Patients endorsed their decision to undergo DBS, 0/10, (0-10), would proceed with surgery again, 0/10 (0-10) and would recommend DBS to others, 0/10 (0-10). At 8.2±2.6 years post-DBS, no change or improvements were seen in UPDRS-II-OFF (p=0.66), UPDRS-IV (p=<0.0001), S&E-ON (p=<0.0001) and S&E-OFF (p=0.71) scores, while UPDRS-I (p=0.0002) and UPDRS-II-ON (p=<0.0001) worsened. PDQ-39-SI scores were, mean (SD), 2.1(18.2) above baseline (p=0.44). Those who met or exceeded pre-DBS expectations showed better PDQ-39-SI scores compared with those whose expectations were not met (2.23 below baseline vs. 14.89 above baseline, p=0.004). Patients whose expectations were met at time of survey reported sustained improvement in self-rated motor symptoms compared with those whose expectations were not met (p=0.0002). This was also seen in self-reported non-motor symptoms (p=0.04).
Conclusions: Satisfaction with DBS is maintained 8.2±2.6 years after surgery, with most patients meeting/exceeding pre-DBS expectations. In general, patients would choose to have surgery again and recommend DBS to others. In those whose expectations were met, quality of life was maintained, confirming the importance of setting realistic expectations.
To cite this abstract in AMA style:
J. Karl, B. Ouyang, K. Colletta, L. Verhagen. Patient-centered outcomes of DBS in Parkinson’s disease [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/patient-centered-outcomes-of-dbs-in-parkinsons-disease/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/patient-centered-outcomes-of-dbs-in-parkinsons-disease/