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. 2017 Aug:41:25-30.
doi: 10.1016/j.parkreldis.2017.04.010. Epub 2017 Apr 17.

Parkinson's disease patient preference and experience with various methods of DBS lead placement

Sara C LaHue  1 , Jill L Ostrem  1 , Nicholas B Galifianakis  1 , Marta San Luciano  1 , Nathan Ziman  2 , Sarah Wang  1 , Caroline A Racine  3 , Philip A Starr  3 , Paul S Larson  3 , Maya Katz  4
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Parkinson's disease patient preference and experience with various methods of DBS lead placement

Sara C LaHue et al. Parkinsonism Relat Disord. 2017 Aug.

Abstract

Introduction: Physiology-guided deep brain stimulation (DBS) surgery requires patients to be awake during a portion of the procedure, which may be poorly tolerated. Interventional MRI-guided (iMRI) DBS surgery was developed to use real-time image guidance, obviating the need for patients to be awake during lead placement.

Methods: All English-speaking adults with PD who underwent iMRI DBS between 2010 and 2014 at our Center were invited to participate. Subjects completed a structured interview that explored perioperative preferences and experiences. We compared these responses to patients who underwent the physiology-guided method, matched for age and gender.

Results: Eighty-nine people with PD completed the study. Of those, 40 underwent iMRI, 44 underwent physiology-guided implantation, and five underwent both methods. There were no significant differences in baseline characteristics between groups. The primary reason for choosing iMRI DBS was a preference to be asleep during implantation due to: 1) a history of claustrophobia; 2) concerns about the potential for discomfort during the awake physiology-guided procedure in those with an underlying pain syndrome or severe off-medication symptoms; or 3) non-specific fear about being awake during neurosurgery.

Conclusion: Participants were satisfied with both DBS surgery methods. However, identification of the factors associated with a preference for iMRI DBS may allow for optimization of patient experience and satisfaction when choices of surgical methods for DBS implantation are available.

Keywords: Deep brain stimulation surgery; Parkinson's disease; Patient satisfaction.

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