Global Variability in Deep Brain Stimulation Practices for Parkinson's Disease

Area of Science:

• Neurosurgery
• Neurology
• Movement Disorders

Background:

• Deep brain stimulation (DBS) is a standard treatment for Parkinson's disease (PD).
• Current practices for patient selection and surgical procedures lack standardization.

Purpose of the Study:

• To investigate current practices in DBS referral and peri-operative management for Parkinson's disease.
• To identify variations in DBS candidate selection, target choice, and postoperative care.

Main Methods:

• A 58-question web-based survey was distributed globally to DBS centers.
• Survey respondents included specialists from Centers of Excellence and professional societies.

Main Results:

• High variability observed in DBS candidate selection, target choice (STN vs. GPi), and postoperative management.
• Cognitive and mood assessments were underutilized; multidisciplinary teams and psychosocial factors had low impact.
• Significant practice differences noted across global regions, particularly concerning multidisciplinary team involvement.

Conclusions:

• Current DBS practices for Parkinson's disease exhibit considerable heterogeneity worldwide.
• Underutilization of assessments and limited reliance on multidisciplinary input highlight a need for standardized guidelines.
• Prospective studies are essential to develop evidence-based guidelines for DBS care.