Objective: To prospectively assess the long-term outcome of subthalamic nucleus (STN) deep brain stimulation (DBS) and the relationship with patients’ expectations and satisfaction.

Background: Subthalamic nucleus stimulation is well-established in the treatment of patients with advanced Parkinson’s disease. It results in objective improvements in motor symptoms and health-related quality of life. Patient satisfaction with surgical intervention, however, is variable and may be influenced by their individual expectations.

Methods: Twenty-two consecutive patients undergoing STN stimulation completed a modified 39-item Parkinson’s disease questionnaire (PDQ-39) pre-operatively. They were assessed at 6 months and a mean 6 (4-7) years after surgery with a post-operative questionnaire consisting of the PDQ-39 and a separate satisfaction scale.

Results: Most patients expressed satisfaction and felt that surgery had fulfilled their expectations (mean scores of 75.3 +/- 17.8 and 73.3 +/- 25.3 on a visual analogue scale from 0 to 100) despite a significant difference between expected and actual change: median PDQ-39 summary scores of 24.0 (interquartile range 15.0) and 14.0 (22.5) respectively, p = 0.008. Satisfaction was sustained over time with predictors of low satisfaction identified at long-term follow-up. Mean patient age was 59.8 years with a median disease duration of 11 years.

Conclusions: Patient satisfaction correlated with fulfillment of their expectations (r = 0.910, p < 0.001) rather than quantitative changes in the PDQ-39 scores. This suggests that managing patients’ expectations both pre- and post-operatively may be crucial in determining the overall outcome of STN stimulation in Parkinson’s disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-prospective-study-of-patients-expectations-in-subthalamic-nucleus-deep-brain-stimulation-for-parkinsons-disease/