The safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with Parkinson’s disease
Jing Zhang,1,* Tao Wang,1,* Chen-cheng Zhang,1 Kristina Zeljic,2 Shikun Zhan,1 Bo-min Sun,1 Dian-you Li1 1Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 2Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China *The...
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Dove Medical Press
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oai:doaj.org-article:d4d1724628784734ac5dd98122b897602021-12-02T03:13:33ZThe safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with Parkinson’s disease1178-1998https://doaj.org/article/d4d1724628784734ac5dd98122b897602017-06-01T00:00:00Zhttps://www.dovepress.com/the-safety-issues-and-hardware-related-complications-of-deep-brain-sti-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Jing Zhang,1,* Tao Wang,1,* Chen-cheng Zhang,1 Kristina Zeljic,2 Shikun Zhan,1 Bo-min Sun,1 Dian-you Li1 1Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 2Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China *These authors contributed equally to this work Introduction: Deep brain stimulation (DBS) is a well-established therapy for the treatment of advanced Parkinson’s disease (PD) in patients experiencing motor fluctuations and medication-refractory tremor. Despite the relative tolerability and safety of this procedure, associated complications and unnatural deaths are still unavoidable.Methods: In this study, hardware-related complications and the causes of unnatural death were retrospectively analyzed in 478 patients with PD who were treated with DBS.Results: The results showed a 3-year survival rate of 98.6% and a 5-year survival rate of 96.4% for patients with PD who underwent DBS treatment at the study center. Pneumonia was the cause of death with the highest frequency. Prophylactic antibiotics and steroids or antihistamine drugs were adopted to reduce the risk of infection. Twenty-two patients (4.6%) experienced hardware-related complications.Conclusion: Deaths of PD patients who receive DBS are typically unrelated to the disease itself or complications associated with the surgery. Pneumonia, malignant tumors, asphyxia, and multiple-organ failure are the common causes of death. Swallowing-related problems may be the most important clinical symptom in late-stage PD, as they cannot be stabilized or improved by DBS alone, and are potentially lethal. Although prophylactic antibiotics and steroids or antihistamine drugs may reduce the risk of infection, it is imperative to identify high-risk patients for whom a therapeutic approach not requiring an implantable device is more suitable, for example, pallidotomy and potentially transcranial ultrasound. Keywords: motor fluctuations, tolerability, death, survival, antibiotics, steroidsZhang JWang TZhang CZeljic KZhan SSun BLi DDove Medical Pressarticleneurodegenerative disordersdyskinesiaimplantable pulse generatorcause of deathsubthalamic nucleusglobus pallidus internaldeep brain stimulationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 923-928 (2017) |
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| collection |
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neurodegenerative disorders dyskinesia implantable pulse generator cause of death subthalamic nucleus globus pallidus internal deep brain stimulation Geriatrics RC952-954.6 |
| spellingShingle |
neurodegenerative disorders dyskinesia implantable pulse generator cause of death subthalamic nucleus globus pallidus internal deep brain stimulation Geriatrics RC952-954.6 Zhang J Wang T Zhang C Zeljic K Zhan S Sun B Li D The safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with Parkinson’s disease |
| description |
Jing Zhang,1,* Tao Wang,1,* Chen-cheng Zhang,1 Kristina Zeljic,2 Shikun Zhan,1 Bo-min Sun,1 Dian-you Li1 1Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 2Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China *These authors contributed equally to this work Introduction: Deep brain stimulation (DBS) is a well-established therapy for the treatment of advanced Parkinson’s disease (PD) in patients experiencing motor fluctuations and medication-refractory tremor. Despite the relative tolerability and safety of this procedure, associated complications and unnatural deaths are still unavoidable.Methods: In this study, hardware-related complications and the causes of unnatural death were retrospectively analyzed in 478 patients with PD who were treated with DBS.Results: The results showed a 3-year survival rate of 98.6% and a 5-year survival rate of 96.4% for patients with PD who underwent DBS treatment at the study center. Pneumonia was the cause of death with the highest frequency. Prophylactic antibiotics and steroids or antihistamine drugs were adopted to reduce the risk of infection. Twenty-two patients (4.6%) experienced hardware-related complications.Conclusion: Deaths of PD patients who receive DBS are typically unrelated to the disease itself or complications associated with the surgery. Pneumonia, malignant tumors, asphyxia, and multiple-organ failure are the common causes of death. Swallowing-related problems may be the most important clinical symptom in late-stage PD, as they cannot be stabilized or improved by DBS alone, and are potentially lethal. Although prophylactic antibiotics and steroids or antihistamine drugs may reduce the risk of infection, it is imperative to identify high-risk patients for whom a therapeutic approach not requiring an implantable device is more suitable, for example, pallidotomy and potentially transcranial ultrasound. Keywords: motor fluctuations, tolerability, death, survival, antibiotics, steroids |
| format |
article |
| author |
Zhang J Wang T Zhang C Zeljic K Zhan S Sun B Li D |
| author_facet |
Zhang J Wang T Zhang C Zeljic K Zhan S Sun B Li D |
| author_sort |
Zhang J |
| title |
The safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with Parkinson’s disease |
| title_short |
The safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with Parkinson’s disease |
| title_full |
The safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with Parkinson’s disease |
| title_fullStr |
The safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with Parkinson’s disease |
| title_full_unstemmed |
The safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with Parkinson’s disease |
| title_sort |
safety issues and hardware-related complications of deep brain stimulation therapy: a single-center retrospective analysis of 478 patients with parkinson’s disease |
| publisher |
Dove Medical Press |
| publishDate |
2017 |
| url |
https://doaj.org/article/d4d1724628784734ac5dd98122b89760 |
| work_keys_str_mv |
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