Abstract
BackgroundThere is an ongoing discussion about age limits for deep brain stimulation (DBS). Current indications for DBS are tremor-dominant disorders, Parkinson's disease, and dystonia. Electrode implantation for DBS with analgesia and sedation makes surgery more comfortable, especially for elderly patients. However, the value of DBS in terms of benefit-risk ratio in this patient population is still uncertain.MethodsBilateral electrode implantation into the subthalamic nucleus (STN) was performed in a total of 73 patients suffering from Parkinson's disease. Patients were analyzed retrospectively. For this study they were divided into two age groups: group I (age <65 years, n = 37) and group II (age ≥ 65 years, n = 36). Examinations were performed preoperatively and at 6-month follow-up intervals for 24 months postoperatively. Age, UPDRS motor score (part III) on/off, Hoehn & Yahr score, Activity of Daily Living (ADL), L-dopa medication, and complications were determined.ResultsSignificant differences were found in overall performance determined as ADL scores (group I: 48/71 points, group II: 41/62 points [preoperatively/6-month postoperatively]) and in the rate of complications (group I: 4 transient psychosis, 4 infections in a total of 8 patients, group II: 2 deaths [unrelated to surgery], 1 intracerebral hemorrhage, 7 transient psychosis, 3 infections, 2 pneumonia in a total of 13 patients), (p < 0.05). Interestingly, changes in UPDRS scores, Hoehn & Yahr scores, and L-dopa medication were not statistically different between the two groups.ConclusionDBS of the STN is clinically as effective in elderly patients as it is in younger ones. However, a more careful selection and follow-up of the elderly patients are required because elderly patients have a higher risk of surgery-related complications and a higher morbidity rate.
Highlights
There is an ongoing discussion about age limits for deep brain stimulation (DBS)
The study presented here aimed at determining whether subthalamic nucleus (STN) DBS is as effective in elderly patients as it is in younger ones and whether there are any differences in the long-term outcome of treatment between older and younger patients
Since there were no significant differences in patient age and performance, in the complication rate and in the results of the DBS, we summarized the two centers
Summary
There is an ongoing discussion about age limits for deep brain stimulation (DBS). Current indications for DBS are tremor-dominant disorders, Parkinson's disease, and dystonia. Electrode implantation for DBS with analgesia and sedation makes surgery more comfortable, especially for elderly patients. The value of DBS in terms of benefit-risk ratio in this patient population is still uncertain. Chronic high-frequency deep brain stimulation (DBS) has evolved into an established therapeutic approach for treating patients with extrapyramidal movement disorders, in particular patients with Parkinson's disease. DBS effectively suppresses tremor and rigor as well as akinesia and dyskinesia [1-14]. BMC Neurology 2007, 7:7 http://www.biomedcentral.com/1471-2377/7/7 ferred surgical target for DBS in Parkinson's disease [4,12,15-20]. Adverse events associated with STN stimulation are quite common with a high incidence of mental changes though these are typically transient in nature [21-30]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
