<p>Deep brain Stimulation (DBS) surgery effectively alleviates troublesome motor symptoms of Parkinson’s disease (PD) such as tremor, rigidity, bradykinesia, motor fluctuations and dyskinesia. It also improves some non-motor symptoms and quality of life. DBS should thus be considered when these symptoms interfere with quality of life despite optimal medical treatment. While DBS benefits are clear, access by eligible patients remains low. Patients and their caregivers should be educated regarding DBS surgery and referrals for surgical evaluation should occur alongside ongoing medication adjustments—particularly when those changes fail to adequately control motor symptoms—regardless of the stage of disease progression. This international panel of DBS experts developed consensus recommendations with the goals of promoting timely referrals and approvals, while reducing misconceptions and stigma associated with brain surgery. These recommendations provide a framework for referring providers, ensuring that appropriate candidates receive timely access to this beneficial treatment.</p>

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Consensus expert recommendations for referral of Parkinson’s disease patients for deep brain stimulation surgery

  • Delaram Safarpour,
  • Meredith Spindler,
  • Travis H. Turner,
  • Neepa Patel,
  • Okeanis Vaou,
  • Laura Y. Cabrera,
  • Christopher Tolleson,
  • Philip W. Tipton,
  • Camila Aquino,
  • Todd M. Herrington,
  • Christos Sidiropoulos,
  • Nathan Hantke,
  • Mitesh Lotia,
  • Svjetlana Miocinovic,
  • Vibhash D. Sharma,
  • Kelly A. Mills,
  • Kathryn Wyman-Chick,
  • Camilla Kilbane,
  • Corneliu Luca,
  • Leonardo Almeida,
  • Joshua Rosenow,
  • Hwai Yin Ooi,
  • Zoltan Mari,
  • Lan Luo,
  • Renato P. Munhoz,
  • Sol De Jesus,
  • Harini Sarva,
  • Monica Arena,
  • Gonzalo Revuelta,
  • Kelvin L. Chou,
  • Alfonso Fasano,
  • Mustafa S. Siddiqui,
  • Joohi Jimenez-Shahed,
  • Renato P. Munhoz,
  • Sol De Jesus,
  • Alfonso Fasano

摘要

Deep brain Stimulation (DBS) surgery effectively alleviates troublesome motor symptoms of Parkinson’s disease (PD) such as tremor, rigidity, bradykinesia, motor fluctuations and dyskinesia. It also improves some non-motor symptoms and quality of life. DBS should thus be considered when these symptoms interfere with quality of life despite optimal medical treatment. While DBS benefits are clear, access by eligible patients remains low. Patients and their caregivers should be educated regarding DBS surgery and referrals for surgical evaluation should occur alongside ongoing medication adjustments—particularly when those changes fail to adequately control motor symptoms—regardless of the stage of disease progression. This international panel of DBS experts developed consensus recommendations with the goals of promoting timely referrals and approvals, while reducing misconceptions and stigma associated with brain surgery. These recommendations provide a framework for referring providers, ensuring that appropriate candidates receive timely access to this beneficial treatment.