Perspectives on Deep Brain Stimulation and Its Earlier Use for Parkinson's Disease: A Qualitative Study of US Patients

Abstract

Background: Deep brain stimulation (DBS) is being used earlier than was previously the case in the disease progression in people with Parkinson's disease (PD). To explore preferences about the timing of DBS, we asked PD patients with DBS whether they would have preferred the implantation procedure to have occurred earlier after diagnosis.

Methods: Twenty Michigan-based patients were interviewed about both their experiences with DBS as well as their attitudes regarding the possible earlier use of DBS. We used a structured interview, with both closed and open-ended questions. Interviews were transcribed verbatim and analyzed using a mixed-methods approach.

Results: We found that the majority of our participants (72%) had high overall satisfaction with DBS in addressing motor symptoms (mean of 7.5/10) and quality of life (mean of 8.25/10). Participants were mixed about whether they would have undergone DBS earlier than they did, with five participants being unsure and the remaining nearly equally divided between yes and no.

Conclusion: Patient attitudes on the early use of DBS were mixed. Our results suggest that while patients were grateful for improvements experienced with DBS, they would not necessarily have endorsed its implementation earlier in their disease progression. Larger studies are needed to further examine our findings.

Keywords: Parkinson’s disease; deep brain stimulation; earlier use; patients’ perspectives.

Figure 1

Factors driving patients’ responses about having DBS earlier. (A) Percentage of responses by gender; (B) Number of participants’ responses by time with implant; (C) Number of participants’ responses by age at DBS surgery; (D) Number of participants’ responses by level of satisfaction with DBS addressing motor symptoms.