Complication risk of deep brain stimulation similar for older, younger Parkinson patients

Older patients with Parkinson disease (PD) who undergo deep brain stimulation (DBS) appear to have a 90-day complication risk similar to younger patients, suggesting that age alone should not be a primary factor for excluding patients as DBS candidates.

For patients with advanced PD who have involuntary movements, DBS has been found to be an effective treatment for reducing motor disability and improving quality of life. Recent studies suggest that DBS plus medical therapy is better than medical therapy alone for patients with PD and early motor complications. Most clinical studies have excluded patients older than 75 years of age, although no specific age cutoff has been set.

The authors analyzed data from 1,757 patients who underwent DBS for PD from 2000 to 2009. The average age of the patients was 61 years; 582 patients (33.1 percent) were 65 years or older and 123 patients (7 percent) were 75 years or older.

Of the 1,757 patients, 132 (7.5 percent) had at least one complication within 90 days, including wound infections (3.6 percent), pneumonia (2.3 percent), hemorrhage or hematoma (1.4 percent) or pulmonary embolism (0.6 percent). Increasing age (from younger than 50 to 90 years) did not significantly impact overall 90-day complication rates.

"This suggests a possible expansion of the therapeutic window traditionally considered for DBS candidates, or at least the removal of age as a rigid exclusion criterion," researchers note.

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The JAMA Network Journals   press release

Publication

Michael R. DeLong, Kevin T. Huang, John Gallis, Yuliya Lokhnygina, Beth Parente, Patrick Hickey, Dennis A. Turner, Shivanand P. Lad. Effect of Advancing Age on Outcomes of Deep Brain Stimulation for Parkinson Disease.   JAMA Neurology, Published Online August 25 2014. doi: 10.1001/jamaneurol.2014.1272