Category: Surgical Therapy: Parkinson's Disease
Objective: We describe the results of a unique cross border collaboration to deliver BDS for Parkinson’s disease in Ireland.
Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established advanced therapy for the management of motor fluctuations and dyskinesia in Parkinson’s disease (PD) where refractory to best medical therapy. Benefits of surgery in reducing OFF time and troublesome dyskinesia in PD are sustained in long term follow-up. Although the use of DBS has become standard of care for the management of motor complications in PD over the past three decades, access to it and alternative device-aided therapies is not universal. Prior to the development of a functional neurosurgery centre in Dublin, a unique cross-border collaboration with a surgical centre in the United Kingdom evolved to make use of surgical elements of deep brain stimulation delivery that were unavailable locally.
Method: We report outcomes from 21 Irish patients with Parkinson’s disease referred to London for neurosurgery following completion of assessment in Dublin.
Results: Significant improvements were observed in Unified Parkinson’s Disease Rating Scale (UPDRS) III scores in the OFF-med/ON-stim condition compared to OFF-med/OFF-stim at 6 months (43.38±9.9 to 18.71 ± 10.1, 57% improvement, P<0.001) and 1 year (45.14±14.29 to 20.5 ± 10.83, 55% improvement, p<0.001). Levodopa Equivalent Dose (LED) was reduced by 51% from 1015.95±413.5mg at baseline to 515.73±191.56mg at 1 year (p=<0.001). Mean OFF time decreased by 69% at 1 year post surgery (p < 0.001). There was a 22% improvement in PDQ-39 from 41.52 ± 20.9 to 32.33 ± 21.8 at 1 year (P =0.008).
Conclusion: The early outcome data we present for this hybrid model of deep brain stimulation delivery is supportive and well within expected norms seen in conventional single-centre delivery. Our experience supports the use of local expertise and the utilisation of surgical skills in another country to provide access to life changing surgery and support the evolution of a more comprehensive service.
To cite this abstract in AMA style:
E. Donlon, S. Abdullah, F. Ronan, M. Garvey, N. Austin, E. Reynolds, F. Ruggieri, T. Lynch, C. Fearon, C. Moran, E. Pereira, R. Walsh. Early Outcomes Support use of a Remote Cross-Border Surgical Centre for Deep Brain Stimulation in Parkinson’s Disease [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/early-outcomes-support-use-of-a-remote-cross-border-surgical-centre-for-deep-brain-stimulation-in-parkinsons-disease/. Accessed May 16, 2025.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/early-outcomes-support-use-of-a-remote-cross-border-surgical-centre-for-deep-brain-stimulation-in-parkinsons-disease/