Objective: To evaluate the outcomes and complications of deep brain stimulation (DBS) and ablative surgery in patients with Parkinson’s disease (PD) in our center.

Background: Advanced therapies for PD, such as DBS and lesional surgery, have shown effectiveness in controlling motor fluctuations and dyskinesias. However, patient selection and individualized evaluation are crucial to optimizing outcomes. Our study presents a retrospective analysis of patients undergoing these procedures in our center.

Method: Between October 2022 and October 2024, 74 patients with PD were evaluated for surgical treatment. Clinical, psychiatric, and neuropsychological assessments, as well as brain MRI studies, were performed. The multidisciplinary team discussed each case for surgical indication. Nine patients underwent surgery: seven received subthalamic nucleus (STN) radiofrequency ablation, and two underwent bilateral STN-DBS implantation. Clinical evolution, medication adjustments, and complications were analyzed postoperatively.

Results: Patients who underwent STN-DBS showed improvement in motor symptoms and quality of life but presented challenges in programming and side effects such as dyskinesias and neuropsychiatric symptoms. One patient who underwent ablative surgery developed “brittle dyskinesia” postoperatively, requiring pharmacological adjustments. Ablative surgery provided symptomatic relief with reduced medication requirements, though some patients experienced transient movement disorders. Our complication rates were consistent with existing literature.

Conclusion: Both ablative surgery and DBS are effective therapeutic options in appropriately selected PD patients. Our initial experience aligns with global reports, highlighting the need for a multidisciplinary approach and long-term follow-up. Further studies with larger sample sizes are needed to refine patient selection criteria and optimize outcomes.

Quality of life hypodopaminergic syndromes

Motor progression total dose of levodopa

Caso of “brittle dyskinesia”

References: Judith, D., & Richard, D. (2016). An economic evaluation of deep brain stimulation for patients with Parkinson’s disease. Movement Disorders, 31(8), 1122-1124. https://doi.org/10.1002/MDS.26701

Francesc, V., Ossama, M., Eduardo, T., Jordi, R., María José, M., & Pablo, M.-M. (2007). Prospective comparative study on cost-effectiveness of subthalamic stimulation and best medical treatment in advanced Parkinson’s disease. Movement Disorders, 22(15), 2183-2191. https://doi.org/10.1002/MDS.21652

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-and-lesional-surgery-in-parkinsons-disease-our-experience-in-santa-cruz-de-la-sierra-bolivia/