Objective: To determine whether DBS is really an absolute contraindication in patients with Parkinson’s dementia.

Background: It is well established in the literature that Parkinson’s patients with dementia are generally not the preferred candidates to undergo DBS due to potential worsening of dementia and cognitive decline.

Method: A PubMed search was done using the keywords (Parkinson’s disease with Dementia) AND (DBS), (STN DBS) AND (GPi DBS), (Dementia in PD) AND (DBS) The search yielded 106 articles published in past six years, and relevant ones were reviewed.

Results: DBS is one of the surgical modality used frequently in patients with advanced Parkinson’s disease to primarily manage motor symptoms and recent studies have shown its positive outcome even in non-motor symptoms. Despite STN-DBS was associated with cognitive decline but long-term studies have shown [1] their prognosis is almost same as normal PD patients. In fact known to improve quality of life for patients undergoing the procedure despite little decline in outcomes.[2] Latest studies have proved GPi-DBS to be much superior to STN-DBS for patients with vulnerable cognitive function [3] despite lower reduction in PD medication dosage compared to STN-DBS, GPi-DBS had better overall outcome on the patients quality of life and significant improvement in MDS-UPDRS II scores only after GPi-DBS, suggested a possible superiority of this target over STN on motor experiences of daily living in patients.

Conclusion: Hence, in patients of PD of Dementia DBS is still a valuable treatment method to improve quality of life especially GPi-DBS is better than STN-DBS.

References: 1. Bove F, Fraix V, Cavallieri F, Schmitt E, Lhommée E, Bichon A, Meoni S, Pélissier P, Kistner A, Chevrier E, Ardouin C, Limousin P, Krack P, Benabid AL, Chabardès S, Seigneuret E, Castrioto A, Moro E. Dementia and subthalamic deep brain stimulation in Parkinson disease: A long-term overview. Neurology. 2020 Jul 28;95(4):e384-e392. doi: 10.1212/WNL.0000000000009822. Epub 2020 Jul 1. PMID: 32611633.
2. Starr PA, Shivacharan RS, Goldberg E, Tröster AI, House PA, Giroux ML, Hebb AO, Whiting DM, Leichliter TA, Ostrem JL, Metman LV, Sani S, Karl JA, Siddiqui MS, Tatter SB, Haq IU, Machado AG, Gostkowski M, Tagliati M, Mamelak AN, Okun MS, Foote KD, Moguel-Cobos G, Ponce FA, Pahwa R, Lyons K, Buetefisch CM, Gross RE, Luca CC, Jagid JR, Revuelta GJ, Takacs I, Pourfar MH, Mogilner AY, Duker AP, Mandybur GT, Rosenow JM, Zadikoff C, Khandhar SM, Sedrak M, Phibbs FT, Neimat J, Durphy J, Ramirez-Zamora A, Pilitsis JG, Uitti RJ, Wharen R, Park MC, Vitek JL; INTREPID Study Group. Five-Year Outcomes from Deep Brain Stimulation of the Subthalamic Nucleus for Parkinson Disease. JAMA Neurol. 2025 Nov 1;82(11):1181-1190. doi: 10.1001/jamaneurol.2025.3373. PMID: 40952750; PMCID: PMC12439180.
3. Mainardi M, Ciprietti D, Pilleri M, Bonato G, Weis L, Cianci V, Biundo R, Ferreri F, Piacentino M, Landi A, Guerra A, Antonini A. Deep brain stimulation of globus pallidus internus and subthalamic nucleus in Parkinson’s disease: a multicenter, retrospective study of efficacy and safety. Neurol Sci. 2024 Jan;45(1):177-185. doi: 10.1007/s10072-023-06999-z. Epub 2023 Aug 9. PMID: 37555874; PMCID: PMC10761504.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/should-we-really-forget-dbs-in-parkinsons-patients-with-dementia/