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Acta Neurochirurgica

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29-09-2023 | Deep Brain Stimulation | Original Article

Complications of deep brain stimulation in Parkinson’s disease: a single-center experience of 517 consecutive cases

Authors: Domenico Servello, Tommaso Francesco Galbiati, Guglielmo Iess, Brigida Minafra, Mauro Porta, Claudio Pacchetti

Published in: Acta Neurochirurgica | Issue 11/2023

Abstract

Background

The number of deep brain stimulation (DBS) procedures is rapidly rising as well as the novel indications. Reporting adverse events related to surgery and to the hardware used is essential to define the risk-to-benefit ratio and develop novel strategies to improve it.

Objective

To analyze DBS complications (both procedure-related and hardware-related) and further assess potential predictive factors.

Methods

Five hundred seventeen cases of DBS for Parkinson’s disease were performed between 2006 and 2021 in a single center (mean follow-up: 4.68 ± 2.86 years). Spearman’s Rho coefficient was calculated to search for a correlation between the occurrence of intracerebral hemorrhage (ICH) and the number of recording tracks. Multiple logistic regression analyzed the probability of developing seizures and ICH given potential risk factors. Kaplan-Meier curves were performed to analyze the cumulative proportions of hardware-related complications.

Results

Mortality rate was 0.2%, while permanent morbidity 0.6%. 2.5% of cases suffered from ICH which were not influenced by the number of tracks used for recordings. 3.3% reported seizures that were significantly affected by perielectrode brain edema and age. The rate of perielectrode brain edema was significantly higher for Medtronic’s leads compared to Boston Scientific’s (Χ²(1)= 5.927, P= 0.015). 12.2% of implants reported Hardware-related complications, the most common of which were wound revisions (7.2%). Internal pulse generator models with smaller profiles displayed more favorable hardware-related complication survival curves compared to larger designs (X²(1)= 8.139, P= 0.004).

Conclusion

Overall DBS has to be considered a safe procedure, but future research is needed to decrease the rate of hardware-related complications which may be related to both the surgical technique and to the specific hardware’s design. The increased incidence of perielectrode brain edema associated with certain lead models may likewise deserve future investigation.

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Title: Complications of deep brain stimulation in Parkinson’s disease: a single-center experience of 517 consecutive cases
Authors: Domenico Servello
Tommaso Francesco Galbiati
Guglielmo Iess
Brigida Minafra
Mauro Porta
Claudio Pacchetti
Publication date: 29-09-2023
Publisher: Springer Vienna
Keywords: Deep Brain Stimulation
Parkinson's Disease
Edema
Wound Dehiscence
Published in: Acta Neurochirurgica / Issue 11/2023
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-023-05799-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Complications of deep brain stimulation in Parkinson’s disease: a single-center experience of 517 consecutive cases

Abstract

Background

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

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