Objective: This case series was designed to highlight non-traditional patients with movement disorders who received Deep Brain Stimulation (DBS) and benefitted from therapy, in an effort to identify common factors that need-not-be exclusionary in considering candidacy for DBS.

Background: The advent of DBS is arguably the most revolutionary advance so far in the treatment of a variety of movement disorders for nearly two decades now. Despite a well-established and published understanding of the factors that predict good and bad outcomes in the patient selection process, DBS specialists have learned with experience that there is an “art” to the candidacy process and that the benefit of DBS can indeed outweigh the risks in patients not traditionally recognized as good candidates.

Method: A total of 30 “non-traditional” Movement Disorder patients who received DBS and benefited positively were identified by their DBS specialists and then systematically reviewed. The patients included those with PD (n=17), ET (n=6), dystonia (n=5), and PD-ET-spectrum disorder (n=2).  In the second phase of the study, both the physician and patient will be asked to rate the outcomes of DBS in terms of both symptomatic benefit and improvement in quality-of-life post-operatively through a Likert-based survey.

Results: Of the 30 non-traditional patients who received DBS, there were several common features identified that would normally be considered contraindications for receiving DBS therapy. The features that made these patients “non-traditional” included the presence of: other neurologic dysfunction (n=11), advanced age (n=9), serious non-neurologic co-morbid conditions (n=4), evidence of cognitive dysfunction (n=2), high-surgical risk (n=2) and questionable known benefit of DBS (n=2).  The results of the aforementioned post-operative survey will be presented by the time of the conference.

Conclusion: Recognition of these nontraditional candidates who have had successful DBS therapy and demonstrated symptomatic improvement as well as improvements in quality-of-life opens the door for future patients to be considered for DBS therapy who normally would not be even be referred for DBS candidacy evaluation. This case series underscores the importance of an individualized patient approach for evaluating patients who may benefit from DBS.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-case-series-highlighting-non-traditional-movement-disorder-candidates-for-deep-brain-stimulation-therapy-who-benefited-positively/