Patients’ Expectations and Satisfaction in Subthalamic Nucleus Deep Brain Stimulation for Parkinson Disease: 6-Year Follow-up

Hsin Ying Lin, Harutomo Hasegawa, Nilesh Mundil, Michael Samuel, Keyoumars Ashkan

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Objective: Patients’ expectations are considered to play an important role in subthalamic nucleus (STN) deep brain stimulation (DBS). We explored the relationship among expectations, satisfaction, and outcome 6 years after surgery. Methods: Fifteen patients with Parkinson disease (9 males, mean age 60.5 ± 6.4 years) undergoing STN DBS completed a modified PDQ-39 questionnaire (incorporating an assessment of patients’ expected changes in addition to the standard quality of life items) preoperatively and at 6 years postoperatively. A satisfaction questionnaire accompanied the postoperative questionnaire. Results: At 6 years’ follow-up, PDQ-39 scores were unchanged from preoperative scores except in the stigma domain, which showed significant improvement. There was no significant difference between the postoperatively rated expected PDQ-39 summary score and the postoperative actual PDQ-39 summary score. However, there was a significant difference between the preoperatively rated expected PDQ-39 summary score and the postoperative actual PDQ-39 summary score. Patients remained highly satisfied with the outcome of surgery (mean satisfaction score 83%). Satisfaction did not correlate with PDQ-39 summary scores, domain scores, or fulfilment of expectations. The more satisfied patients (satisfaction ≥80%) changed their expectations so that their postoperatively rated expectations reflected a less favorable condition, whereas no such change was seen in the less satisfied (satisfaction <80%) patients. Conclusions: Patients remain highly satisfied with STN DBS 6 years after surgery, although quality of life assessed by the PDQ-39 may return to baseline levels. Patients’ expectations change over time and may influence patient satisfaction. Managing expectations before and after surgery plays an essential role in STN DBS.

Original languageEnglish
Pages (from-to)e654-e660
JournalWorld Neurosurgery
Volume121
DOIs
Publication statusPublished - Jan 2019

Keywords

  • Deep brain stimulation
  • Expectations
  • Parkinson disease
  • Satisfaction
  • Subthalamic nucleus

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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