What is the patient evaluation and selection process for individuals with Parkinson disease (PD) considering subthalamic nucleus (STN) deep brain stimulation (DBS)?

Updated: Jan 24, 2019
  • Author: Robert A Hauser, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Answer

First, a neurologist with expertise in movement disorders evaluates the patient. Patient selection is particularly important for successful subthalamic nucleus (STN) deep brain stimulation (DBS), because a number of factors determine positive surgical outcome. [93, 94] These can be summarized as follows:

  • A diagnosis of Parkinson disease

  • Positive response to levodopa

  • Absence of atypical parkinsonian features

  • Advanced disease, virtually unmanageable with dopaminergic medications

  • Relatively young age; however, advanced age (>75 years) is not an absolute contraindication to surgery (if a patient otherwise meets the selection criteria for a procedure and the quality of life is predicted to improve substantially, surgery should be offered)

  • No significant cognitive impairment

  • Absence of active psychiatric disease

  • Good social support and access to programming


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