Re: DBS Adverse Events: Results from 1154 PD Patients

[rayilynlee <rayilynlee@xxxxxxx>]

I feel lucky I was helped by DBS.  I feel like mentally I am sharper, no 
more ocular
migraines, am never depressed , no more shaking, speaking is a real problem 
though.  My other PD symptoms seem to have plateaued  - no meds.

Ray
Rayilyn Brown
Board Member AZNPF
Arizona Chapter National Parkinson's Foundation
rbrown@xxxxxxxxx
----- Original Message ----- 
From: "M.Schild" <mmoo@xxxxxxxxxxxxxxxx>
To: <PARKINSN@xxxxxxxxxxxxxxxxxxxx>
Sent: Friday, March 28, 2008 12:23 PM
Subject: DBS Adverse Events: Results from 1154 PD Patients


> Deep brain stimulation for Parkinson's disease: Prevalence of adverse 
> events
> and need for standardized reporting
> A Videnovic, L Verhagen Metman
> Movement Disorders 2008;23:343-349
>
>
> Adverse events related to deep brain stimulation are common, but their 
> true
> prevalence cannot be accurately determined with current reporting methods,
> according to this study.
>
> The authors analyzed reports of adverse events from 47 studies of STN and 
> GPi
> DBS in PD published from 1996 to 2007, representing 1,154 patients (928 
> STN,
> 226 GPi) and 2,205 electrode placements. They grouped AEs into three 
> classes:
> procedure-related, hardware-related, and stimulation- or disease
> progression-related events.
>
> The most common events were:
>
> Procedure-related events:
> STN (%) GPi (%)
> Mental status/behavioral 18.4 9.3
> Infection 2 2.6
> ICH-symptomatic 2 4
> Misplaced electrode 1.7 2
> Speech disturbance 1.5 3.9
> Infarction 0.2 2.2
>
> Among mental status changes, confusion was by far the most common.
>
> Hardware-related events (combined GPi and STN, %):
> Infection 2.4
> Malfunctioning 1
> Lack of benefit 0.9
>
> A total of 8.7% of patients experienced one or more hardware-related AE.
>
> Stimulation- or progression-related events, which did not disappear with
> adjustment (%):
> STN (%) GPi (%)
> Weight gain 37.5 17.6
> Dysarthria 12.8 11.8
> Eyelid opening apraxia 11.3 0
> Gait ignition failure 0 17.6
>
> Because of the variation in classification of AE reporting among the 
> included
> studies, the authors note that "a retrospective review of the available
> literature cannot provide accurate data on the prevalence of AEs 
> associated
> with DBS in PD." They recommend the adoption of a standardized system for 
> AE
> reporting in DBS trials, in which all AEs are classified along the lines 
> they
> employed in this study, plus the temporal characteristics of the AE and 
> its
> response to programming adjustments.

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