gms | German Medical Science

Objective: The study evaluates long-term complications of deep brain stimulation (DBS) surgery for Parkinson’s disease (PD). A number of studies deal with short term DBS-surgery complications. However long-term complications (>30 days post-surgery) are described in only few reports.

Methods: Retrospective analysis of PD patients treated in our department from 2007 to June 2016. N=540 patients with DBS-implantation were included in the analysis. Primary parameters were infections, electrode dislocation, bleedings, granulomas, and stimulator dysfunction. Secondary parameters were new onset of gait disturbance, depression, REM sleep disturbance, hormonal disturbance, cardiac symptoms, cerebrovascular incidents, new tumors, alcohol abuse, nicotine abuse, autoimmune diseases, metabolic disturbance, polyneuropathy, pain syndromes and adipositas. The data was compared with the cohort of age matched patients with medical treatment.

Results: Mean follow-up was 8 years. Mean patient age was 63 years, and female: male ratio was 1:1,6. Long term complication could be seen in 43/540 patients (8%). 2.6% had an infection, 0.8% electrode dislocation, 0.8% scar granuloma, 1.1% an intracerebral bleeding, 1.1% an extracerebral hematoma and 2.3% needed stimulator removal due to infection or mechanical complication. The rate of new onset falls in the DBS treated patients was 2.5%/year and new depression was 2.5%/year. REM sleep disturbance was 2%. There was a significant decrease of falls, depression and REM sleep disturbance of 75% in the DBS treated group compared to medically treated patients cohort.

Conclusion: In this retrospective analysis, we could show that surgical complications of DBS implantation in our center are rare. Falling incidents, new onset of depression and REM sleep disturbance were significantly lower in patients with DBS stimulation compared to age matched patients with medical treatment.