Caregiver Burden and Its Determinants After Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease: A...

Parkinson's disease (PD) is a progressive neurodegenerative disorder, leading to increasing functional dependence even after deep brain stimulation (DBS). Although DBS improves motor outcomes, its long-term impact on caregiver burden remains poorly understood.

Our aims were to evaluate caregiver burden after subthalamic nucleus (STN)-DBS and identify patient- and caregiver-related factors associated with burden across different postoperative time points.

A cross-sectional study of caregivers of PD patients who underwent STN-DBS at a tertiary center, stratified by time since surgery (2-3, 5-6, 10-11, and ≥15 years), was conducted. Caregivers completed the Zarit Burden Interview, Hospital Anxiety and Depression Scale, and an investigator-developed questionnaire. Patient clinical data, including the Unified Parkinson's Disease Rating Scale (UPDRS), Part III, scores, were obtained from medical records. Group comparisons and multivariable regression analyses were performed to identify factors associated with caregiver burden.

Eighty-eight patient-caregiver pairs were included. Caregivers were predominantly female (62.5%), with a mean age of 60.0 ± 12.3 years. Caregiver burden was mild to moderate but increased independently with longer time postsurgery. Higher burden was associated with younger caregiver age, higher anxiety and depression scores, greater caregiving time, less personal time, and patient-related factors, including dysphagia, dementia, and male sex. Motor severity (UPDRS III, falls, postural instability) was not associated with caregiver burden. Most caregivers considered STN-DBS beneficial and would choose surgery again.

Caregiver burden increased with longer time after STN-DBS and was associated with dementia, dysphagia, and caregiver-related factors but not with motor severity. Several associated factors are potentially modifiable, supporting systematic caregiver assessment and targeted interventions as part of long-term PD management.