The impact of sociodemographic factors and surgical modalities on deep brain stimulation for Parkinson's disease.

Surgical neurology international Pub Date : 2025-03-14 eCollection Date: 2025-01-01 DOI:10.25259/SNI_968_2024
David Shin, Miguel Angel Lopez-Gonzalez
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Abstract

Background: This study evaluated the impact of sociodemographic factors, surgical modalities, and commercially available options of electrodes on deep brain stimulation (DBS) outcomes in Parkinson's disease.

Methods: We retrospectively analyzed 59 elective DBS surgeries performed at a single institution from 2016 to 2023. Hoehn and Yahr (HY) scale scores and levodopa equivalent daily dosages (LEDD) were assessed at baseline, 3 months, and 6 months postoperatively. Collected variables included length of stay (LOS), age, sex, race/ethnicity, language, body mass index, insurance status, marital status, religion, type of anesthesia, concurrent pulse generator implantation, location of the implant, and conventional or directional lead. DBS systems included Medtronic, Boston Scientific, and Abbott (also known as St. Jude Medical).

Results: The mean LOS was 2.36 days. Mean HY scores improved from baseline (3.17) to 3 months (2.83) and 6 months (2.85), and LEDD significantly decreased at both 3 and 6 months postoperatively. Divorced patients showcased a significantly larger improvement in HY scores at 3 months compared to other marital groups. Abbott leads were associated with a significantly longer LOS compared to Boston Scientific (+1.85 days) and Medtronic (+2 days). No other variables significantly affected DBS outcomes.

Conclusion: This study investigated the impact of sociodemographic factors and surgical modalities of DBS in PD patients, showcasing how DBS improved motor function and reduced medication usage at 3 and 6 months postoperative. Marital status and lead manufacturer significantly influenced DBS outcomes, highlighting the importance of personalized considerations in DBS management.

社会人口学因素和手术方式对帕金森病深部脑刺激的影响
背景:本研究评估了社会人口学因素、手术方式和商用电极选择对帕金森病深部脑刺激(DBS)结果的影响。方法:回顾性分析2016年至2023年在一家机构进行的59例选择性DBS手术。在基线、术后3个月和6个月分别评估Hoehn和Yahr (HY)评分和左旋多巴当量日剂量(LEDD)。收集的变量包括住院时间(LOS)、年龄、性别、种族/民族、语言、体重指数、保险状况、婚姻状况、宗教信仰、麻醉类型、并发脉冲发生器植入、植入位置、常规或定向引线。DBS系统包括美敦力、波士顿科学和雅培(也被称为St. Jude Medical)。结果:平均生存期为2.36天。平均HY评分从基线(3.17)提高到3个月(2.83)和6个月(2.85),LEDD在术后3个月和6个月均显著降低。与其他婚姻组相比,离婚患者在3个月时的HY评分有了明显的改善。与波士顿科学(+1.85天)和美敦力(+2天)相比,雅培导联的LOS明显更长。没有其他变量显著影响DBS结果。结论:本研究调查了社会人口因素和DBS手术方式对PD患者的影响,展示了DBS在术后3个月和6个月改善运动功能和减少药物使用的效果。婚姻状况和主要制造商显著影响DBS结果,突出了DBS管理中个性化考虑的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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