Deep brain stimulation: postoperative issues

Topic: Risk, prevention and care in population studies

Numerous factors need to be taken into account when managing a patient with Parkinson's disease (PD) after deep brain stimulation (DBS). Questions such as when to begin programming, how to conduct a programming screen, how to assess the effects of programming, and how to titrate stimulation and medication for each of the targeted sites need to be addressed. Follow-up care should be determined, including patient adjustments of stimulation, timing of follow-up visits and telephone contact with the patient, and stimulation and medication conditions during the follow-up assessments. A management plan for problems that can arise after DBS such as weight gain, dyskinesia, axial symptoms, speech dysfunction, muscle contractions, paresthesia, eyelid, ocular and visual disturbances, and behavioral and cognitive problems should be developed. Long-term complications such as infection or erosion, loss of effect, intermittent stimulation, tolerance, and pain or discomfort can develop and need to be managed. Other factors that need consideration are social and job-related factors, development of dementia, general medical issues, and lifestyle changes. This report from the Consensus on Deep Brain Stimulation for Parkinson's Disease, a project commissioned by the Congress of Neurological Surgeons and the Movement Disorder Society, outlines answers to a series of questions developed to address all aspects of DBS postoperative management and decision-making with a systematic overview of the literature (until mid-2004) and by the expert opinion of the authors. The report has been endorsed by the Scientific Issues Committee of the Movement Disorder Society and the American Society of Stereotactic and Functional Neurosurgery.

Key findings

• A management plan for problems that can arise after DBS such as weight gain, dyskinesia, axial symptoms, speech dysfunction, muscle contractions, paresthesia, eyelid, ocular and visual disturbances, and behavioral and cognitive problems should be developed.
• Long-term complications such as infection or erosion, loss of effect, intermittent stimulation, tolerance, and pain or discomfort can develop and need to be managed.
• Other factors that need consideration are social and job-related factors, development of dementia, general medical issues, and lifestyle changes.
• This report from the Consensus on Deep Brain Stimulation for Parkinson's Disease, a project commissioned by the Congress of Neurological Surgeons and the Movement Disorder Society, outlines answers to a series of questions developed to address all aspects of DBS postoperative management and decision-making with a systematic overview of the literature (until mid-2004) and by the expert opinion of the authors.
• The report has been endorsed by the Scientific Issues Committee of the Movement Disorder Society and the American Society of Stereotactic and Functional Neurosurgery.

Why it matters

This report gives guidance on managing problems that can arise after deep brain stimulation in Parkinson's disease, including cognitive problems and the development of dementia. It does not test a treatment, cure or prevention for Alzheimer's disease.

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Study details

• Evidence strengthLow

Read the original

• DOI: 10.1002/mds.20957
• PubMed: 16810719
• Original source →

May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.

@article{deuschl2006-16810719,
  author  = {Deuschl, G. and Herzog, J. and Kleiner-Fisman, G. and Kubu, C. and Lozano, A. M. and Lyons, K. E. and Rodriguez-Oroz, M. C. and Tamma, F. and others},
  title   = {{Deep brain stimulation: postoperative issues}},
  journal = {Movement disorders : official journal of the Movement Disorder Society},
  year    = {2006},
  doi     = {10.1002/mds.20957},
  pmid    = {16810719},
  url     = {https://doi.org/10.1002/mds.20957}
}

Studies this one cites

Referenced by this study and also in the alzhub library, so you can read them here.

• Rivastigmine for dementia associated with Parkinson's disease The New England journal of medicine · 2004-12-01 · usefulness score 78/100 · Treatments
• Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study Archives of neurology · 2003-03-01 · usefulness score 68/100 · Caregiving
• Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson's disease The New England journal of medicine · 2003-11-01 · usefulness score 55/100 · Digital health tools
• Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: persistent improvement in mobility but increased dependency: a case study Movement disorders : official journal of the Movement Disorder Society · 2000-01-01 · usefulness score 40/100 · Digital health tools

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