Lessons learned from a large single center cohort of patients referred for DBS management

Parkinsonism & Related Disorders
Benzi M KlugerMichael S Okun

Abstract

Deep brain stimulation surgery (DBS) for movement disorders has become commonplace and patients are beginning to present to specialized centers for second opinions. We aimed to uncover reasons for referral by analyzing a large single center cohort of DBS patients referred for management. Data were collected prospectively on a cohort of one hundred and eight patients who presented to the UF Movement Disorders Center for management following implantation at outside DBS centers. Data collected included referral reasons, pre-operative evaluation, DBS programming thresholds, DBS placement, need for optimization of therapy, and ultimate patient outcomes. Ninety percent of patients reported at least one area of symptomatic dissatisfaction with the results of their DBS. Common issues included pre-operative misdiagnosis (28%), presence or exacerbation of symptoms not addressable by current DBS technology (48%), lead misplacement (43%), and need for medication (27%) or DBS programming (37%) optimization. Compared with leads placed using microelectrode recording (MER), leads placed without MER were strongly associated with misplacement (p = 0.03). Overall, 42% of subjects had no improvement, 37% slight improvement and 21% large improvemen...Continue Reading

References

Mar 17, 2007·The Clinical Neuropsychologist·Michael S OkunDawn Bowers
May 23, 2007·Movement Disorders : Official Journal of the Movement Disorder Society·Félix Bermejo-ParejaUNKNOWN Neurological Disorders in Central Spain (NEDICES) Study Group
Sep 13, 2007·The Neurologist·Ramon L RodriguezMichael S Okun
Jul 22, 2008·Journal of the Neurological Sciences·Jae-Hyeok HeoBeom S Jeon
Nov 5, 2008·Neurosurgery·Tina-Marie EllisMichael S Okun
Jun 27, 2009·Neurologic Clinics·Benzi M KlugerMichael S Okun
Jun 27, 2009·Neurosurgery Clinics of North America·Philip A StarrPaul S Larson

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Citations

Dec 2, 2015·Neuromodulation : Journal of the International Neuromodulation Society·Dustin A HeldmanFredy J Revilla
Feb 24, 2015·Parkinsonism & Related Disorders·Christopher L PulliamJerrold L Vitek
May 21, 2016·Frontiers in Neuroscience·Patrick Hickey, Mark Stacy
Jun 23, 2018·Journal of Neurosurgery·Leonardo A FrizonAndre G Machado
Apr 5, 2019·Therapeutic Advances in Neurological Disorders·Christian J HartmannAlfons Schnitzler
Apr 20, 2021·Frontiers in Human Neuroscience·Abhimanyu MahajanKelly A Mills
Jun 29, 2021·Frontiers in Bioengineering and Biotechnology·Frédéric ChapelleJean-Jacques Lemaire

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