P180. Serious adverse effects of deep brain stimulation (DBS) in patients with Parkinson's disease (PD) of relatively old age in comparison with the EARLYSTIM study. Issue 8 (August 2015)

• Record Type: Journal Article
• Authors: Cozac, V.; Chaturvedi, M.; Bousleiman, H.; Hatz, F.; Meyer, A.; Schwarz, N.; Zimmermann, R.; Fuhr, P.; Gschwandtner, U.
• Is Part Of: Clinical neurophysiology. Volume 126:Issue 8(2015:Aug.)
• Page Start: e164
• Page End: 622
• Publication Date: 2015-08
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2015.04.276
• Languages: English
• ISSNs: 1388-2457

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title id="st005">Objective</title> <p id="sp005">To investigate the risks of DBS in Parkinson's disease patients of relatively old age (older than 60 years).</p> </sec> <sec> <title id="st010">Methods</title> <p id="sp010">A retrospective sample of 29 non-demented patients with idiopathic PD (age: median 64.0 years ± 7.0; 11 females) was investigated (Basel group). The patients underwent DBS in Basel and Bern, Switzerland. Mean period of follow-up after surgery was 23.8 months. Serious adverse events (SAE) were defined as any event leading to death, disability, prolonged or new hospitalization, according to the Medical Dictionary for Regulatory Activities, Version 14.1. We compared the outcome in the Basel group with the DBS group of EARLYSTIM clinical trial (<xref id="c0005" rid="b0005">Schuepbach et al., 2013</xref>) with a neurostimulation group (age: median 52.9 ± 6.6 years) and a best medical treatment group (age: median 52.2 ± 6.1 years). Chi-square test was used for statistical analysis.</p> </sec> <sec> <title id="st015">Results</title> <p id="sp015">A total of 17 patients (58.6%) in the Basel group had at least one SAE. There were no suicides in the Basel group, but four of the patients deceased during the follow up period. SAE related to psychosis/hallucination (<italic>p</italic> < 0.001) and depression (<italic>p</italic> = 0.004) were significantly different between the Basel group and the EARLYSTIM groups with the result that overall difference of SAE was also different between the groups (<italic>p</italic> = 0.011). In addition there were more motor fluctuations in the Basel group (<italic>p</italic> = 0.02) than in both EARLYSTIM groups.</p> </sec> <sec> <title id="st020">Conclusion</title> <p id="sp020">While the gross profile of SAE is similar in older and younger patients treated with DBS, the incidence of psychosis, depression and motor fluctuation is higher in older patients. Older patients require increased attention to risk factors for neuropsychiatric consequences of DBS.</p> </sec> </abstract>