Weill Cornell Medical College, Weill Cornell Medicine, 1300 York Ave, New York, NY 10065, USA.
Center for Neural Engineering, Department of Engineering Science and Mechanics, Pennsylvania State University, W-316 Millennium Science Complex, University Park, PA 16802, USA.
J Clin Neurosci. 2022 Jan;95:20-26. doi: 10.1016/j.jocn.2021.11.017. Epub 2021 Dec 3.
Research on attitudes regarding the use and timing of deep brain stimulation (DBS) has been mostly qualitative to this date. In this study, we aim to examine attitudes and perceptions about the use and timing of DBS in patients with Parkinson's disease (PD) who have not had DBS. We designed an online survey comprising Likert-type, multiple choice, and rank-order questions and distributed it to PD patients. We recruited participants via flyers, the Michael J. Fox Foundation Trial Finder, and the Parkinson Alliance website. We analyzed considerations for choosing or rejecting DBS and when participants would consider such a decision to be premature. Data were analyzed using descriptive and inferential statistics, including a multinomial logistic regression model. Among the 285 participants who reported not having undergone DBS, the most frequent concerns were related to the efficacy of DBS and not having exhausted medication alternatives. DBS was viewed as less convenient, effective, and safe when PD symptoms were still manageable by medication. Our regression model suggests that having fewer concerns over technical problems was a positive predictor of preferring early DBS, while concerns over DBS interfering with friendships and relationships was a negative predictor. Our results suggest that patients with PD who have not undergone DBS have a wide variety of attitudes regarding DBS and its timing. Given the increasing number of therapeutic options for PD, future work should compare perceptions and preferences regarding different PD treatment modalities to provide the best counseling for patients regarding their therapeutic options.
迄今为止，关于深部脑刺激 (DBS) 的使用和时机的研究主要是定性的。在这项研究中，我们旨在研究尚未接受 DBS 的帕金森病 (PD) 患者对 DBS 的使用和时机的态度和看法。我们设计了一个包含李克特量表、多项选择和排序问题的在线调查，并将其分发给 PD 患者。我们通过传单、迈克尔·J·福克斯基金会试验发现者和帕金森联盟网站招募参与者。我们使用描述性和推断性统计分析，包括多项逻辑回归模型，对选择或拒绝 DBS 的考虑因素以及何时认为此类决定为时过早进行了分析。在报告未接受 DBS 的 285 名参与者中，最常见的担忧与 DBS 的疗效以及尚未用尽药物替代方案有关。当 PD 症状仍可通过药物控制时，DBS 被认为不太方便、有效和安全。我们的回归模型表明，对技术问题的担忧较少是早期接受 DBS 的积极预测因素，而对 DBS 干扰友谊和人际关系的担忧则是负面预测因素。我们的研究结果表明，未接受 DBS 的 PD 患者对 DBS 及其时机有各种各样的看法。鉴于 PD 的治疗选择越来越多，未来的工作应该比较不同 PD 治疗方式的看法和偏好，为患者提供有关治疗选择的最佳咨询。
