Objective: To evaluate the frequency and trends of DBS-related intraoperative, perioperative, and postoperative complications, and changes in disease duration at implantation over time.

Background: Deep brain stimulation (DBS) is an established therapy for selected movement disorders, although implantation-related complications remain an important clinical issue.

Method: We retrospectively reviewed patients with PD who underwent DBS between 2009 and 2025. Complications were classified by timing as intraoperative, perioperative (≤14 days postoperatively), and postoperative events. In addition, we assessed annual mean disease duration at implantation and annual events per procedure (EPP) for intraoperative and perioperative phases.

Results: We retrospectively reviewed patients with PD who underwent DBS between 2009 and 2025. Complications were classified by timing as intraoperative, perioperative (≤14 days postoperatively), and postoperative events. In addition, we assessed annual mean disease duration at implantation and annual events per procedure (EPP) for intraoperative and perioperative phases.Among 115 procedures with available intraoperative data, the most frequent intraoperative complications were peri-lead oedema (6.1%) and transient ischemic attack (4.3%), followed by intracranial hemorrhage (3.5%), arterial hypertension (2.6%), and ischemic stroke (0.9%). With available perioperative data, confusion (9.6%) was most common, followed by infection (5.2%), febrile reactions (4.3%), and hallucinations (4.3%); other perioperative neuropsychiatric and systemic complications were less frequent. Postoperatively, gait impairment predominated (31 patients; 27.0%), with additional neuropsychiatric and sleep-related complications, including cognitive worsening, depression, insomnia, anxiety, and hallucinations. Over the study period, the mean disease duration at implantation showed a decreasing trend, indicating a shift toward earlier DBS implantation in recent years. Annual intraoperative and perioperative EPP remained low with year-to-year variability, without evidence of sustained high complication burden.

Conclusion: DBS implantation was associated with a generally low rate of intraoperative and perioperative complications, while postoperative gait and neuropsychiatric symptoms were more frequent. The decreasing disease duration at implantation suggests a trend toward earlier referral for DBS over time.

References: Rasiah NP, Maheshwary R, Kwon CS, Bloomstein JD, Girgis F. Complications of Deep Brain Stimulation for Parkinson Disease and Relationship between Micro-electrode Tracks and Hemorrhage: Systematic Review and Meta-Analysis. World Neurosurg. 2023;171:e8-e23. doi:10.1016/j.wneu.2022.10.034.
Hacker ML, Meystedt JC, Turchan M, Cannard KR, Harper K, Fan R, et al. Eleven-Year Outcomes of Deep Brain Stimulation in Early-Stage Parkinson Disease. Neuromodulation. 2023;26(2):451-458. doi:10.1016/j.neurom.2022.10.051.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/complications-following-deep-brain-stimulation-in-parkinsons-disease-single-centre-experience-2009-2025/