Shin David, Lopez-Gonzalez Miguel Angel
Department of School of Medicine, Loma Linda University, California, United States.
Department of Neurological Surgery, Loma Linda University Medical Center, Loma Linda, California, United States.
Surg Neurol Int. 2025 Mar 14;16:91. doi: 10.25259/SNI_968_2024. eCollection 2025.
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.
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).
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.
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.
本研究评估了社会人口统计学因素、手术方式以及市售电极选项对帕金森病深部脑刺激(DBS)结果的影响。
我们回顾性分析了2016年至2023年在单一机构进行的59例择期DBS手术。在基线、术后3个月和6个月时评估霍恩和亚尔(HY)量表评分以及左旋多巴等效日剂量(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、麻醉类型、同期脉冲发生器植入情况、植入位置以及传统或定向电极。DBS系统包括美敦力、波士顿科学和雅培(也称为圣犹达医疗)。
平均住院时间为2.36天。平均HY评分从基线时的3.17改善至3个月时的2.83和6个月时的2.85,术后3个月和6个月时LEDD均显著降低。与其他婚姻组相比,离婚患者在3个月时HY评分的改善显著更大。与波士顿科学(+1.85天)和美敦力(+2天)相比,雅培电极与显著更长的住院时间相关。没有其他变量显著影响DBS结果。
本研究调查了帕金森病患者DBS的社会人口统计学因素和手术方式的影响,展示了DBS在术后3个月和6个月时如何改善运动功能并减少药物使用。婚姻状况和电极制造商显著影响DBS结果,突出了DBS管理中个性化考虑的重要性。