Objective: To investigate the safety and efficacy of subthalamic nucleus (STN) deep brain stimulation (DBS) in elderly patients with Parkinson’s disease (PD).

Background: Even though STN DBS is effective treatment option for patients with PD, the age limit for DBS is not clearly elucidated.

Methods: Bilateral STN DBS was done in 55 PD patients from 2012 to 2017. We divided into two groups based on the age at DBS: young group (age < 65 years, n=38) and elderly group (Age  65 years, n=17). For the efficacy, we compared pre and post-DBS unified Parkinson’s disease rating scale (UPDRS) part 4 and levodopa equivalent dose (LED) between young and elderly groups. Additionally, we compared surgery-related complications between two groups.

Results: The mean age of young group is 56.7  5.7, and 68.5  2.8 for elderly group. Although more female underwent STN DBS in younger group (68.4% in young group, and 29.4% in elderly group, p=0.009), there was no difference in disease duration, pre-DBS UPDRS part 3, 4 score, and LED. For safety, 1 complications (transient psychosis) were seen in young group (2.6%), while 2 complications (transient psychosis and intracerebral hemorrhage) in elderly group (12.5%, p=0.223). In terms of efficacy, UPDRS 4 score and LED were significantly improved 6m after DBS in both groups.

Conclusions: STN DBS could be applied in PD elderly patients as well as young PD patients. However, despite lack of statistical significance, more surgical complications should be considered in elderly group.

References: 1. Vesper J, Haak S, Ostertag C, Nikkhah G. Subthalamic nucleus deep brain stimulation in elderly patients–analysis of outcome and complications. BMC Neurol. 2007 Mar 16;7:7. 2. Dafsari HS, Reker P, Stalinski L, Silverdale M, Rizos A et al. Mov Disord. Quality of life outcome after subthalamic stimulation in Parkinson’s disease depends on age. 2018 Jan;33(1):99-107. 3. Dafsari HS, Reker P, Silverdale M, Reddy P, Pilleri M et al. Subthalamic Stimulation Improves Quality of Life of Patients Aged 61 Years or Older With Short Duration of Parkinson’s Disease. Neuromodulation. 2017 Dec 20. doi: 10.1111/ner.12740.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/subthalamic-deep-brain-stimulation-is-safe-and-effective-treatment-for-elderly-patients-with-parkinsons-disease/