Objective: This study investigated the clinical characteristics, therapeutic efficacy and postoperative outcomes of Parkinson’s disease (PD) patients undergoing deep brain stimulation (DBS) revision surgery

Background: The DBS surgery is an effective treatment for advanced PD, providing satisfactory control of motor symptoms in most patients. However, some patients require revision surgery due to insufficient symptom relief or procedure-related complications. Despite its clinical importance, studies on DBS revision surgery remain limited.

Method: A retrospective analysis was conducted on 10 patients (14 DBS leads) who underwent DBS revision or reimplantation surgery at Asan Medical Center between 2009 and 2019. Patient demographics, initial PD symptoms, disease duration, age at first DBS surgery, intervals between initial and revision surgeries for DBS, and reasons for revision surgery were reviewed. The mean follow-up duration after revision surgery was 5.9 years (range: 2–11 years). Postoperative outcomes were assessed based on symptom changes and patient-reported satisfaction.

Results: The mean interval between initial and revision DBS surgery was 3.31 years (range: 0.08–6 years). Among 8 leads revised from subthalamic nucleus (STN) to globus pallidus internus (GPi), only one patient (2 leads, 12.5%) experienced partial tremor improvement, lasting for 3 years, but without meaningful change in other motor symptoms. Of the 4 leads revised from GPi to STN, two patients (3 leads, 75.0%) reported improvement in gait disturbance and freezing of gait; however, all developed speech disturbances. The two leads involving the ventral intermediate nucleus (Vim) target (Vim to GPi, n=1; STN to Vim, n=1) initially showed tremor improvement, but cognitive function declined 1–2 years after revision surgery.

Conclusion: DBS revision surgery provided temporary improvement in gait (from GPi to STN, up to 3 years) or tremor (from Vim to STN, approximately 1 year); however, these effects were maintained short period. These findings emphasize careful patient selection and long-term monitoring to optimize revision outcomes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effectiveness-and-outcomes-of-deep-brain-stimulation-revision-surgery-for-parkinsons-disease/