Objective: Patients diagnosed with PD and other movement disorders should be evaluated for alternative treatment approaches including Deep Brain Stimulation(DBS). In this study, we aimed to investigate the clinical spectrum and demographical features of patients attending to our center and evaluate treatment approaches.

Background: Parkinson’s Disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms. DBS is a commonly used surgical treatment for PD; however, some of the patients are ineligible for DBS surgery. Atypical Parkinsonism patients, rapidly progressive parkinsonism, patients with severe cognitive impairment and dementia, patients with severe psychiatric conditions, brain atrophy and significant strokes and patients with lack of levodopa response are known to be bad candidates for DBS surgery.

Method: A retrospective analysis was conducted on 695 patients who applied to PARMER between 2022-2024 and who was ineligible for DBS surgery. Patients were analyzed based on demographic, clinical, and socioeconomic characteristics. Patients were divided into groups according to their diagnosis as;idiopathic PD, PD Plus, ET(Essential tremor)-PD, pure ET and Dystonia.

Results: The mean age of total subjects attending to our center was  66.05±13.2 years, with 57.41% male and 42.59% female. Among them, 388 patients were diagnosed with idiopathic PD, 95 with PD Plus, 32 with ET-PD, 85 with pure ET, and 10 with Dystonia.The most common comorbid condition was hypertension (22.68%).The mean disease duration in patients diagnosed with PD was found to be 6.36±6.1years.The most common reasons of ineligibility for DBS surgery were;  the lack of optimal dose treatment (42.01%), a disease duration of less than three years (26.03%), and low responsiveness to levodopa (16.75%).Those who were noneligible for DBS surgery were directed to alternative treatment methods.

Conclusion: This study provides significant insights into the evaluation of patients who were ineligible for DBS surgery and highlights the necessity of optimizing medical therapy before considering surgical intervention.These findings emphasize the critical role of comprehensive medical assessment in DBS candidacy determination, guiding patient selection and alternative therapeutic strategies such as device-assisted therapies and physiotherapy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-diversity-of-patients-attending-to-the-istanbul-medipol-university-parkinsons-disease-and-movement-disorders-center-parmer-who-did-not-undergo-dbs-surgery/