Deep Brain Stimulation for Dystonia in the Netherlands: A Delphi Study to Develop National Consensus

Area of Science:

• Neurology
• Neurosurgery
• Medical Device Technology

Background:

• Predicting treatment outcomes for dystonia patients undergoing deep brain stimulation (DBS) is difficult.
• Lack of standardized screening, follow-up, and outcome measures complicates DBS treatment for dystonia.
• This study addresses the need for uniformity in DBS for dystonia care.

Purpose of the Study:

• To achieve national consensus among experts on outcome measures for DBS in dystonia.
• To standardize preoperative screening and follow-up processes for DBS in dystonia.
• To improve the consistency and effectiveness of DBS therapy for dystonia.

Main Methods:

• A modified Delphi process involving national experts in DBS for dystonia.
• Utilized inventory rounds, Delphi questionnaires, and a digital consensus meeting.
• Established a 70% consensus threshold for agreement on various aspects of DBS care.

Main Results:

• Consensus was achieved on 40/59 items for adult DBS and 47/61 items for pediatric DBS after initial rounds.
• A final consensus meeting solidified agreement on 23/28 rephrased statements (11 adult, 11 pediatric, 1 both).
• High levels of agreement were reached on outcome measures, screening, and follow-up protocols.

Conclusions:

• This Delphi study successfully established national consensus among experts regarding DBS for dystonia in adults and children.
• The findings provide a foundation for standardized best practices in DBS for dystonia.
• The results are poised to facilitate future collaborative international research on DBS for dystonia.