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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Deep Brain stimulation in elderly patients

Chronische Tiefenhirnstimulation bei älteren Patienten

Meeting Abstract

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  • corresponding author Jan Vesper - Department of Stereotactic Neurosurgery, Neurocenter, University Clinic Freiburg, Freiburg
  • C. Wille - Department of Neurosurgery, University Medical Center Benjamin Franklin, Berlin
  • T. Prokop - Department of Stereotactic Neurosurgery, Neurocenter, University Clinic Freiburg, Freiburg
  • M. Brock - Department of Neurosurgery, University Medical Center Benjamin Franklin, Berlin
  • C. Ostertag - Department of Stereotactic Neurosurgery, Neurocenter, University Clinic Freiburg, Freiburg
  • G. Nikkhah - Department of Stereotactic Neurosurgery, Neurocenter, University Clinic Freiburg, Freiburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.08.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0083.shtml

Published: April 23, 2004

© 2004 Vesper 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 in Deep Brain Stimulation (DBS). Current indications are tremordominant disorders, Parkinson's disease and dystonia. By means of 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 in a total of 86 patients, suffering from Parkinson's disease. Patients were analyzed retrospectively. For this study they were separated in two groups: Group I (age <65 y, n=45) and group II (age ≥65y, n=41). Examinations were performed preoperative and at 6 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 intermittend psychosis, 3 infections, 2 pneumonia in 13 patients), (p<0,05). Interestingly changes in UPDRS score, Hoehn&Yahr scale, L-DOPA medication were not statistically different among 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 for both surgery related and unrelated complications.