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Determinants of Deep Brain Stimulation Candidacy Failure in Movement Disorders: A Multidisciplinary Analysis
Patricia J Graese1,2, Hikaru Kamo1,3, Kelly D Foote4
1Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida, USA.
Movement Disorders Clinical Practice
|June 10, 2026
Summary
A multidisciplinary approach to deep brain stimulation (DBS) candidacy for movement disorders identified a 10.4% failure rate. Common reasons for DBS failure include cognitive risks and patient expectations.
Area of Science:
- Neurosurgery
- Neurology
- Movement Disorders
Background:
- Deep brain stimulation (DBS) is a key treatment for refractory movement disorders.
- Careful screening is vital to ensure a positive risk-benefit ratio for DBS candidates.
Purpose of the Study:
- To determine the failure rates and underlying causes of multidisciplinary DBS candidacy evaluations.
- Focus on Parkinson's disease (PD), essential tremor (ET), and dystonia.
Main Methods:
- Retrospective chart review of patients evaluated for DBS candidacy.
- Defined "multidisciplinary evaluation failures" (MEF) as tabled or denied cases.
- Analyzed reasons for MEF using descriptive statistics.
Main Results:
- 10.4% of 1758 patients were MEF (182 cases).
- Top reasons for MEF: cognitive risk (62.1%), incongruent expectations (17.6%), psychiatric concerns (16.5%).
- PD comprised the largest diagnostic group among MEF (70.9%).
Conclusions:
- A multidisciplinary approach is crucial for DBS candidate selection.
- Numerous factors can influence the decision to proceed with DBS therapy.
- Careful evaluation mitigates risks associated with DBS treatment.
