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.
Bibliographical noteFunding Information:
BSJ has received funding for travel from Korea Research-Based Pharmaceutical Industry Association and Korean Pharmaceutical Manufacturers Association and has received research support as PI from Ipsen, Norvartis, Boehringer Ingelheim, the Korea Health 21 R&D project, Ministry of Health & Welfare, Republic of Korea, the National Research Foundation of Korea (NRF), Ministry of Education, Science and Technology, ABRC (Advanced Biometric Research Center), KOSEF (Korean Science and Engineering Foundation), Seoul National University Hospital, the Mr. Chung Suk-Gyoo and Sinyang Cultural Foundation, and the Song Foundation. Other authors have no financial disclosures.
This study was supported by a grant from the Korea Health technology R&D Project, Ministry of Health and Welfare , Republic of Korea ( A101273 , JBS).
© 2015 Elsevier Ltd.
- Deep brain stimulation
- Motor control
- Parkinson's disease