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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Subthalamic Nucleus (STN) Deep Brain Stimulation (DBS) in elderly patients: a two year follow-up

Nucleus Subthalamicus (STN) Deep Brain Stimulation (DBS) bei älteren Patienten: ein 2 Jahres follow-up

Meeting Abstract

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  • S. Haack - Abt. Stereotaxie, Neurozentrum, Uniklinik Freiburg
  • corresponding author J. Vesper - Abt. Stereotaxie, Neurozentrum, Uniklinik Freiburg
  • G. Nikkhah - Abt. Stereotaxie, Neurozentrum, Uniklinik Freiburg
  • T. Prokop - Abt. Stereotaxie, Neurozentrum, Uniklinik Freiburg
  • M. Brock - Neurochirurgische Klinik und Poliklinik, Universitätsmedizin in Berlin - Charité, Campus Benjamin Franklin, Berlin
  • C. Ostertag - Abt. Stereotaxie, Neurozentrum, Uniklinik Freiburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP019

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0287.shtml

Published: May 4, 2005

© 2005 Haack et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

There is an ongoing discussion regarding age limits of patients considered for Deep Brain Stimulation (DBS). Current indications are tremordominant disorders, Parkinson’s disease and dystonia. By using analgosedation, DBS surgery is more comfortable, especially for elderly patients. However, the value of DBS regarding the benefit-risk ratio in this patient population is still uncertain.

Methods

Bilateral electrode implantation in the STN was performed at two centers in a total of 73 patients, suffering from Parkinson‘s disease. Patients were analyzed retrospectively. For this study they were separated into two groups: Group I (age <65y, n=37) and group II (age ≥65y, n=36). Examinations were performed before the opration, at 6, 12 and 24 months follow-up. Age, UPDRS motor score (part III) on/off, Hoehn&Yahr scale, Activity of Daily Living (ADL), L-Dopa medication and complications were determined. SigmaStat (Jandel scientific) was used for statistical evaluation.

Results

Significant differences were found regarding the overall perfomance in the ADL score (group I: 48/71, group II: 41/62 points [preop/6 mo postop]) and in the rate of complications (group I: 4 intermittend psychosis, 4 infections in 8 patients, group II: 2 deaths [unrelated to surgery], 1 intracerebral hemorrhage, 7 intermittent psychosis, 3 infections, 2 pneumonia in 13 patients), (p<0,05). Interestingly changes in UPDRS score, Hoehn&Yahr scale, L-DOPA medication showed no statistic difference between the two groups.

Conclusions

DBS in the STN is as effective in elderly patients as it is in the younger ones. However, careful selection and follow-up is required because of the higher risk of complications found in the elderly patient population.