Mi-Ryoung Kim1, Ji Young Yun2, Beomseok Jeon3, Yong Hoon Lim1, Kyung Ran Kim1, Hui-Jun Yang4, Sun Ha Paek5. 1. Department of Neurosurgery, Movement Disorder Center and Neuroscience Research Institute, Seoul National University Hospital, Seoul, Republic of Korea. 2. Department of Neurology, Ewha Womans University Mokdong Hospital and Ewha Womans University School of Medicine, Seoul, Republic of Korea. 3. Department of Neurology, Movement Disorder Center and Neuroscience Research Institute, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: brain@snu.ac.kr. 4. Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea. 5. Department of Neurosurgery, Movement Disorder Center and Neuroscience Research Institute, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: paeksh@snu.ac.kr.
Abstract
BACKGROUND: Many patients with advanced Parkinson's disease (PD) are reluctant to undergo the subthalamic nucleus deep brain stimulation (STN-DBS) when surgery is warranted. Reasons for this reluctance have not been examined. We undertook to establish the rate and causes of this reluctance for STN-DBS in patients with advanced PD. METHODS: A reluctant group was defined as patients who were hesitant to undergo DBS. Clinical information included age, onset age, disease duration, the Unified Parkinson Disease Rating Scale, Hoehn and Yahr stage and levodopa equivalent dose when they were evaluated with a view to consider surgery. RESULTS: We enrolled 186 patients who underwent STN-DBS. 84 patients (45%) belonged to the reluctant group. Between the reluctant and the non-reluctant, there were no differences in preoperative characteristics. Main reasons for hesitation were fear of complications (74%) and economic burden (50%). The main reasons that they finally underwent the DBS were confidence in the doctor's decision (80%) and encouragement from their family (36%). CONCLUSIONS: Building trust between patients and physicians is an important factor in guiding patients to undergo this treatment. To reduce the reluctance to undergo DBS at the appropriate time, we need to find effective ways of reducing their psychological and economic burden.
BACKGROUND: Many patients with advanced Parkinson's disease (PD) are reluctant to undergo the subthalamic nucleus deep brain stimulation (STN-DBS) when surgery is warranted. Reasons for this reluctance have not been examined. We undertook to establish the rate and causes of this reluctance for STN-DBS in patients with advanced PD. METHODS: A reluctant group was defined as patients who were hesitant to undergo DBS. Clinical information included age, onset age, disease duration, the Unified Parkinson Disease Rating Scale, Hoehn and Yahr stage and levodopa equivalent dose when they were evaluated with a view to consider surgery. RESULTS: We enrolled 186 patients who underwent STN-DBS. 84 patients (45%) belonged to the reluctant group. Between the reluctant and the non-reluctant, there were no differences in preoperative characteristics. Main reasons for hesitation were fear of complications (74%) and economic burden (50%). The main reasons that they finally underwent the DBS were confidence in the doctor's decision (80%) and encouragement from their family (36%). CONCLUSIONS: Building trust between patients and physicians is an important factor in guiding patients to undergo this treatment. To reduce the reluctance to undergo DBS at the appropriate time, we need to find effective ways of reducing their psychological and economic burden.
Authors: Tove Henriksen; Kim Peder Dalhoff; Henriette Engel Hansen; Andreas W Brenneche; Ulla Sofie Lønberg; Erik Hvid Danielsen Journal: Mov Disord Clin Pract Date: 2020-07-02
Authors: Marieke G M Weernink; Janine A van Til; Jeroen P P van Vugt; Kris L L Movig; Catharina G M Groothuis-Oudshoorn; Maarten J IJzerman Journal: PLoS One Date: 2016-08-30 Impact factor: 3.240