Objective: To describe the outcomes of patients undergoing deep brain stimulation (DBS) surgery for movement disorders and neuropsychiatric indications and characterise delirium symptoms.

Background: Deep brain stimulation (DBS) is a well-established therapy for PD, with improvements in motor fluctuations and dyskinesias(1). DBS is also an established therapy for other movement disorders and OCD. DBS involves the implantation of stimulation electrodes via stereotactic surgery to target particular brain areas with high frequency electrical stimulation to bring about therapeutic effects(1). It is recognized that people with PD are more likely to experience post-operative delirium in general. It typically develops within 72 hours of surgery, though can be take up to five days to manifest(1). There is limited research regarding the rates and risk factors, characteristics and sequalae of delirium after DBS.

Method: The study was approved by Epworth Hospital ethics committee. Hospital inpatient data was retrieved from Epworth Hospital for 2017-2024 inclusive, in patients undergoing DBS for any indication. Delirium was identified by hospital coding and later by screening the clinical notes. A subgroup of 35 patients underwent routine post-operative screening for delirium and characteristics and outcomes will be explored.

Results: 124 patients underwent DBS insertion or electrode revision for a total of 127 procedures. The average age on admission was 62.2 years with 84 (66.1%) being male. Eight of these procedures were for OCD. Twenty-one patients were identified by hospital coding as having delirium (16.5%). In patients screened for delirium, visuospatial dysfunction was common (31.42%). Inattention, with 3 or less digits on reverse digit span was common, at 51.4%. Further cognitive and behavioural characteristics will be presented.

Conclusion: Cognitive changes consistent with delirium were extremely common in the 2-3 days postoperatively following DBS surgery, suggesting that delirium may be significantly underdiagnosed. The longer term consequences of these changes are unknown due to lack of screening and research and require further study.

References: 1. Li H, Han S, Feng J. Delirium after Deep Brain Stimulation in Parkinson’s Disease. Parkinsons Dis. 2021 Feb 1;2021:1–9.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/delirium-following-deep-brain-stimulation-an-8-year-single-centre-study/