Objective: We aim to assess the subjective impression on effectiveness and safety of Subthalamic nucleus Deep Brain Stimulation Surgery (STN-DBS) in patients with Parkinson’s Disease (PD) through a structured interview (pilot study) to the patients and caregivers.

Background: DBS surgery is an established treatment choice for selective cases of advanced Parkinson’s Disease. Several reports have demonstrated the effectiveness and safety of DBS based on objective clinical measures. However, the patient reported outcomes have been rarely explored in this field.

Method: PD patients who underwent DBS surgery at least one year prior to the assessment were recruited. The questionnaire for assessment was validated by collating opinion from four neurologists and neuroscientists. In this questionnaire nine items were designed for patient-response and five items were for caregivers. In each question, the responders were requested to rate their experience as percent improvement/deterioration from the baseline (presurgical state).

Results: Among the 17 recruited patients we observed that although 76% perceived an initial improvement soon after the DBS surgery, over time 59% retained the positive effect. Close family members reported 50% (IQR 30-70) median improvement after the surgery. In our small cohort of 17 patients, 14 and 12 patients reported decline in cognitive function and psychiatric symptoms respectively after DBS surgery. Eleven patients noticed a deterioration in their walking.

Conclusion: A substantial number of patients suffered from cognitive decline, psychiatric symptoms, speech problems and walking difficulty over a period even after an initial improvement. It is in line with the studies reported by Karl et al. 2018, USA who found that 65% (n=52) were satisfied with DBS outcome and Maier et al. 2016, Germany who reported that 43% (n=28) patients were satisfied with the surgery.

References: 1. Karl JA, Ouyang B, Colletta K, Verhagen Metman L. Long-term satisfaction and patient-centered outcomes of deep brain stimulation in Parkinson’s disease. Brain sciences. 2018 Apr 1;8(4):60.
2. Maier F, Lewis CJ, Horstkoetter N, Eggers C, Dembek TA, Visser-Vandewalle V, Kuhn J, Zurowski M, Moro E, Woopen C, Timmermann L. Subjective perceived outcome of subthalamic deep brain stimulation in Parkinson’s disease one year after surgery. Parkinsonism & related disorders. 2016 Mar 1;24:41-7.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effectiveness-of-subthalamic-nucleus-stn-deep-brain-stimulation-surgery-dbs-in-patients-with-parkinsons-disease-a-patient-and-caregiver-reported-outcome/