Adverse events in deep brain stimulation: A retrospective long-term analysis of neurological, psychiatric and other occurrences. Buhmann, C., Huckhagel, T., Engel, K., Gulberti, A., Hidding, U., Poetter-Nerger, M., Goerendt, I., Ludewig, P., Braass, H., Choe, C. U., Krajewski, K., Oehlwein, C., Mittmann, K., Engel, A. K., Gerloff, C., Westphal, M., Koppen, J. A., Moll, C. K. E., & Hamel, W. PLoS One, 12(7):e0178984, 2017. ![Adverse events in deep brain stimulation: A retrospective long-term analysis of neurological, psychiatric and other occurrences [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex BACKGROUND AND OBJECTIVE: The extent to which deep brain stimulation (DBS) can improve quality of life may be perceived as a permanent trade-off between neurological improvements and complications of therapy, comorbidities, and disease progression. PATIENTS AND METHODS: We retrospectively investigated 123 consecutive and non-preselected patients. Indications for DBS surgery were Parkinson's disease (82), dystonia (18), tremor of different etiology (21), Huntington's disease (1) and Gilles de la Tourette syndrome (1). AEs were defined as any untoward clinical occurrence, sign or patient complaint or unintended disease if related or unrelated to the surgical procedures, implanted devices or ongoing DBS therapy. RESULTS: Over a mean/median follow-up period of 4.7 years (578 patient-years) 433 AEs were recorded in 106 of 123 patients (86.2%). There was no mortality or persistent morbidity from the surgical procedure. All serious adverse events (SAEs) that occurred within 4 weeks of surgery were reversible. Neurological AEs (193 in 85 patients) and psychiatric AEs (78 in 48 patients) were documented most frequently. AEs in 4 patients (suicide under GPI stimulation, weight gain \textgreater20 kg, impairment of gait and speech, cognitive decline \textgreater2 years following surgery) were severe or worse, at least possibly related to DBS and non reversible. In PD 23.1% of the STN-stimulated patients experienced non-reversible (or unknown reversibility) AEs that were at least possibly related to DBS in the form of impaired speech or gait, depression, weight gain, cognitive disturbances or urinary incontinence (severity was mild or moderate in 15 of 18 patients). Age and Hoehn&Yahr stage of STN-simulated PD patients, but not preoperative motor impairment or response to levodopa, showed a weak correlation (r = 0.24 and 0.22, respectively) with the number of AEs. CONCLUSIONS: DBS-related AEs that were severe or worse and non-reversible were only observed in PD (4 of 82 patients; 4.9%), but not in other diseases. PD patients exhibited a significant risk for non-severe AEs most of which also represented preexisting and progressive axial and non-motor symptoms of PD. Mild gait and/or speech disturbances were rather frequent complaints under VIM stimulation. GPI stimulation for dystonia could be applied with negligible DBS-related side effects.
@article{buhmann2017,
title = {Adverse events in deep brain stimulation: {A} retrospective long-term analysis of neurological, psychiatric and other occurrences},
volume = {12},
issn = {1932-6203 (Electronic) 1932-6203 (Linking)},
url = {https://www.ncbi.nlm.nih.gov/pubmed/28678830},
doi = {10.1371/journal.pone.0178984},
abstract = {BACKGROUND AND OBJECTIVE: The extent to which deep brain stimulation (DBS) can improve quality of life may be perceived as a permanent trade-off between neurological improvements and complications of therapy, comorbidities, and disease progression. PATIENTS AND METHODS: We retrospectively investigated 123 consecutive and non-preselected patients. Indications for DBS surgery were Parkinson's disease (82), dystonia (18), tremor of different etiology (21), Huntington's disease (1) and Gilles de la Tourette syndrome (1). AEs were defined as any untoward clinical occurrence, sign or patient complaint or unintended disease if related or unrelated to the surgical procedures, implanted devices or ongoing DBS therapy. RESULTS: Over a mean/median follow-up period of 4.7 years (578 patient-years) 433 AEs were recorded in 106 of 123 patients (86.2\%). There was no mortality or persistent morbidity from the surgical procedure. All serious adverse events (SAEs) that occurred within 4 weeks of surgery were reversible. Neurological AEs (193 in 85 patients) and psychiatric AEs (78 in 48 patients) were documented most frequently. AEs in 4 patients (suicide under GPI stimulation, weight gain {\textgreater}20 kg, impairment of gait and speech, cognitive decline {\textgreater}2 years following surgery) were severe or worse, at least possibly related to DBS and non reversible. In PD 23.1\% of the STN-stimulated patients experienced non-reversible (or unknown reversibility) AEs that were at least possibly related to DBS in the form of impaired speech or gait, depression, weight gain, cognitive disturbances or urinary incontinence (severity was mild or moderate in 15 of 18 patients). Age and Hoehn\&Yahr stage of STN-simulated PD patients, but not preoperative motor impairment or response to levodopa, showed a weak correlation (r = 0.24 and 0.22, respectively) with the number of AEs. CONCLUSIONS: DBS-related AEs that were severe or worse and non-reversible were only observed in PD (4 of 82 patients; 4.9\%), but not in other diseases. PD patients exhibited a significant risk for non-severe AEs most of which also represented preexisting and progressive axial and non-motor symptoms of PD. Mild gait and/or speech disturbances were rather frequent complaints under VIM stimulation. GPI stimulation for dystonia could be applied with negligible DBS-related side effects.},
number = {7},
journal = {PLoS One},
author = {Buhmann, C. and Huckhagel, T. and Engel, K. and Gulberti, A. and Hidding, U. and Poetter-Nerger, M. and Goerendt, I. and Ludewig, P. and Braass, H. and Choe, C. U. and Krajewski, K. and Oehlwein, C. and Mittmann, K. and Engel, A. K. and Gerloff, C. and Westphal, M. and Koppen, J. A. and Moll, C. K. E. and Hamel, W.},
year = {2017},
keywords = {Adolescent Adult Aged Deep Brain Stimulation/*adverse effects/*methods Dystonia/etiology Female Follow-Up Studies Gait Disorders, Health Care/methods/statistics \& numerical data Quality of Life Retrospective Studies Speech Disorders/etiology Tremor/etiology Young Adult, Neurologic/etiology Humans Male Mental Disorders/*etiology Middle Aged Nervous System Diseases/*etiology Outcome Assessment},
pages = {e0178984},
annote = {Buhmann, Carsten Huckhagel, Torge Engel, Katja Gulberti, Alessandro Hidding, Ute Poetter-Nerger, Monika Goerendt, Ines Ludewig, Peter Braass, Hanna Choe, Chi-Un Krajewski, Kara Oehlwein, Christian Mittmann, Katrin Engel, Andreas K Gerloff, Christian Westphal, Manfred Koppen, Johannes A Moll, Christian K E Hamel, Wolfgang eng 2017/07/06 PLoS One. 2017 Jul 5;12(7):e0178984. doi: 10.1371/journal.pone.0178984. eCollection 2017.},
}
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E.","Hamel, W."],"bibdata":{"bibtype":"article","type":"article","title":"Adverse events in deep brain stimulation: A retrospective long-term analysis of neurological, psychiatric and other occurrences","volume":"12","issn":"1932-6203 (Electronic) 1932-6203 (Linking)","url":"https://www.ncbi.nlm.nih.gov/pubmed/28678830","doi":"10.1371/journal.pone.0178984","abstract":"BACKGROUND AND OBJECTIVE: The extent to which deep brain stimulation (DBS) can improve quality of life may be perceived as a permanent trade-off between neurological improvements and complications of therapy, comorbidities, and disease progression. PATIENTS AND METHODS: We retrospectively investigated 123 consecutive and non-preselected patients. Indications for DBS surgery were Parkinson's disease (82), dystonia (18), tremor of different etiology (21), Huntington's disease (1) and Gilles de la Tourette syndrome (1). AEs were defined as any untoward clinical occurrence, sign or patient complaint or unintended disease if related or unrelated to the surgical procedures, implanted devices or ongoing DBS therapy. RESULTS: Over a mean/median follow-up period of 4.7 years (578 patient-years) 433 AEs were recorded in 106 of 123 patients (86.2%). There was no mortality or persistent morbidity from the surgical procedure. All serious adverse events (SAEs) that occurred within 4 weeks of surgery were reversible. Neurological AEs (193 in 85 patients) and psychiatric AEs (78 in 48 patients) were documented most frequently. AEs in 4 patients (suicide under GPI stimulation, weight gain \\textgreater20 kg, impairment of gait and speech, cognitive decline \\textgreater2 years following surgery) were severe or worse, at least possibly related to DBS and non reversible. In PD 23.1% of the STN-stimulated patients experienced non-reversible (or unknown reversibility) AEs that were at least possibly related to DBS in the form of impaired speech or gait, depression, weight gain, cognitive disturbances or urinary incontinence (severity was mild or moderate in 15 of 18 patients). Age and Hoehn&Yahr stage of STN-simulated PD patients, but not preoperative motor impairment or response to levodopa, showed a weak correlation (r = 0.24 and 0.22, respectively) with the number of AEs. CONCLUSIONS: DBS-related AEs that were severe or worse and non-reversible were only observed in PD (4 of 82 patients; 4.9%), but not in other diseases. PD patients exhibited a significant risk for non-severe AEs most of which also represented preexisting and progressive axial and non-motor symptoms of PD. Mild gait and/or speech disturbances were rather frequent complaints under VIM stimulation. GPI stimulation for dystonia could be applied with negligible DBS-related side effects.","number":"7","journal":"PLoS One","author":[{"propositions":[],"lastnames":["Buhmann"],"firstnames":["C."],"suffixes":[]},{"propositions":[],"lastnames":["Huckhagel"],"firstnames":["T."],"suffixes":[]},{"propositions":[],"lastnames":["Engel"],"firstnames":["K."],"suffixes":[]},{"propositions":[],"lastnames":["Gulberti"],"firstnames":["A."],"suffixes":[]},{"propositions":[],"lastnames":["Hidding"],"firstnames":["U."],"suffixes":[]},{"propositions":[],"lastnames":["Poetter-Nerger"],"firstnames":["M."],"suffixes":[]},{"propositions":[],"lastnames":["Goerendt"],"firstnames":["I."],"suffixes":[]},{"propositions":[],"lastnames":["Ludewig"],"firstnames":["P."],"suffixes":[]},{"propositions":[],"lastnames":["Braass"],"firstnames":["H."],"suffixes":[]},{"propositions":[],"lastnames":["Choe"],"firstnames":["C.","U."],"suffixes":[]},{"propositions":[],"lastnames":["Krajewski"],"firstnames":["K."],"suffixes":[]},{"propositions":[],"lastnames":["Oehlwein"],"firstnames":["C."],"suffixes":[]},{"propositions":[],"lastnames":["Mittmann"],"firstnames":["K."],"suffixes":[]},{"propositions":[],"lastnames":["Engel"],"firstnames":["A.","K."],"suffixes":[]},{"propositions":[],"lastnames":["Gerloff"],"firstnames":["C."],"suffixes":[]},{"propositions":[],"lastnames":["Westphal"],"firstnames":["M."],"suffixes":[]},{"propositions":[],"lastnames":["Koppen"],"firstnames":["J.","A."],"suffixes":[]},{"propositions":[],"lastnames":["Moll"],"firstnames":["C.","K.","E."],"suffixes":[]},{"propositions":[],"lastnames":["Hamel"],"firstnames":["W."],"suffixes":[]}],"year":"2017","keywords":"Adolescent Adult Aged Deep Brain Stimulation/*adverse effects/*methods Dystonia/etiology Female Follow-Up Studies Gait Disorders, Health Care/methods/statistics & numerical data Quality of Life Retrospective Studies Speech Disorders/etiology Tremor/etiology Young Adult, Neurologic/etiology Humans Male Mental Disorders/*etiology Middle Aged Nervous System Diseases/*etiology Outcome Assessment","pages":"e0178984","annote":"Buhmann, Carsten Huckhagel, Torge Engel, Katja Gulberti, Alessandro Hidding, Ute Poetter-Nerger, Monika Goerendt, Ines Ludewig, Peter Braass, Hanna Choe, Chi-Un Krajewski, Kara Oehlwein, Christian Mittmann, Katrin Engel, Andreas K Gerloff, Christian Westphal, Manfred Koppen, Johannes A Moll, Christian K E Hamel, Wolfgang eng 2017/07/06 PLoS One. 2017 Jul 5;12(7):e0178984. doi: 10.1371/journal.pone.0178984. eCollection 2017.","bibtex":"@article{buhmann2017,\n\ttitle = {Adverse events in deep brain stimulation: {A} retrospective long-term analysis of neurological, psychiatric and other occurrences},\n\tvolume = {12},\n\tissn = {1932-6203 (Electronic) 1932-6203 (Linking)},\n\turl = {https://www.ncbi.nlm.nih.gov/pubmed/28678830},\n\tdoi = {10.1371/journal.pone.0178984},\n\tabstract = {BACKGROUND AND OBJECTIVE: The extent to which deep brain stimulation (DBS) can improve quality of life may be perceived as a permanent trade-off between neurological improvements and complications of therapy, comorbidities, and disease progression. PATIENTS AND METHODS: We retrospectively investigated 123 consecutive and non-preselected patients. Indications for DBS surgery were Parkinson's disease (82), dystonia (18), tremor of different etiology (21), Huntington's disease (1) and Gilles de la Tourette syndrome (1). AEs were defined as any untoward clinical occurrence, sign or patient complaint or unintended disease if related or unrelated to the surgical procedures, implanted devices or ongoing DBS therapy. RESULTS: Over a mean/median follow-up period of 4.7 years (578 patient-years) 433 AEs were recorded in 106 of 123 patients (86.2\\%). There was no mortality or persistent morbidity from the surgical procedure. All serious adverse events (SAEs) that occurred within 4 weeks of surgery were reversible. Neurological AEs (193 in 85 patients) and psychiatric AEs (78 in 48 patients) were documented most frequently. AEs in 4 patients (suicide under GPI stimulation, weight gain {\\textgreater}20 kg, impairment of gait and speech, cognitive decline {\\textgreater}2 years following surgery) were severe or worse, at least possibly related to DBS and non reversible. In PD 23.1\\% of the STN-stimulated patients experienced non-reversible (or unknown reversibility) AEs that were at least possibly related to DBS in the form of impaired speech or gait, depression, weight gain, cognitive disturbances or urinary incontinence (severity was mild or moderate in 15 of 18 patients). Age and Hoehn\\&Yahr stage of STN-simulated PD patients, but not preoperative motor impairment or response to levodopa, showed a weak correlation (r = 0.24 and 0.22, respectively) with the number of AEs. CONCLUSIONS: DBS-related AEs that were severe or worse and non-reversible were only observed in PD (4 of 82 patients; 4.9\\%), but not in other diseases. PD patients exhibited a significant risk for non-severe AEs most of which also represented preexisting and progressive axial and non-motor symptoms of PD. Mild gait and/or speech disturbances were rather frequent complaints under VIM stimulation. GPI stimulation for dystonia could be applied with negligible DBS-related side effects.},\n\tnumber = {7},\n\tjournal = {PLoS One},\n\tauthor = {Buhmann, C. and Huckhagel, T. and Engel, K. and Gulberti, A. and Hidding, U. and Poetter-Nerger, M. and Goerendt, I. and Ludewig, P. and Braass, H. and Choe, C. U. and Krajewski, K. and Oehlwein, C. and Mittmann, K. and Engel, A. K. and Gerloff, C. and Westphal, M. and Koppen, J. A. and Moll, C. K. 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