Candidate profile and clinical characteristics of patients undergoing STN-DBS surgery for advanced Parkinson's disease: A single-center experience
Gülce Coşku Yılmaz Çakan1
, Gökhan Gürkan2, Ali Akay2, Özge Yılmaz Küsbeci1
1İzmir Ekonomi Üniversitesi, Nöroloji Anabilim Dalı, İzmir, Türkiye
2İzmir Ekonomi Üniversitesi, Nöroşirurji Anabilim Dalı, İzmir, Türkiye
Keywords: Deep brain stimulation, Parkinson’s disease, subthalamic nucleus.
Abstract
Background: This study aims to evaluate the clinical and demographic characteristics of patients with Parkinson's disease (PD) who underwent bilateral subthalamic nucleus deep brain stimulation (STN-DBS) and to characterize the real-world surgical candidate profile of our center.
Materials and Methods: Eighteen patients with idiopathic PD, diagnosed according to the Movement Disorder Society clinical diagnostic criteria, with a disease duration of at least five years and considered to have advanced-stage disease, who underwent bilateral STN-DBS were included in the study. All patients were evaluated for STN-DBS eligibility by a multidisciplinary team in accordance with the Delphi consensus criteria. Demographic and clinical characteristics, as well as comorbidities, were recorded. Data were summarized using descriptive statistics, and appropriate parametric or non-parametric tests were applied for between-group comparisons.
Results: The mean age of the patients included in the study was 59.5 ± 15.8 years. Initial motor symptoms were right-sided in 61.1% of patients. The akinetic-rigid phenotype was present in 66.7% of patients, while 33.3% had a tremor-dominant phenotype at disease onset. The mean age at disease onset was 47.1 ± 16.7 years, the mean age at STN-DBS surgery was 57.1 ± 15.6 years, and the mean disease duration at the time of surgery was 10.1 ± 3.4 years. The mean preoperative levodopa equivalent daily dose (LEDD) was 778 ± 345 mg. Comparisons according to sex, initial motor phenotype, and side of symptom onset revealed no significant differences in age, disease duration, or LEDD (all p > 0.05). Comorbidities included diabetes mellitus in 16.7% of patients, hypertension in 11.1%, and hyperlipidemia in 5.6%.
Conclusion: This study characterizes the surgical candidate profile of patients with Parkinson's disease undergoing STN-DBS at a tertiary referral center. A multidisciplinary evaluation process based on objective consensus criteria may support consistent candidate selection across different clinical phenotypes. These findings provide insight into current DBS candidate selection and underscore the need for future studies evaluating postoperative outcomes.