Time To Stable Programming After Staged vs Simultaneous Bilateral Subthalamic Deep Brain Stimulation Electrode Placement for Parkinson's Disease.

OBJECTIVE

To compare programming visits and time to stable stimulation and medication management after staged versus simultaneous bilateral subthalamic nucleus deep brain stimulation (DBS) for Parkinson's disease.

METHODS

This retrospective study included the original selected cohort of 10 staged and 10 simultaneous bilateral DBS patients, matched during cohort selection by age, disease duration, and surgical year. Continuous and count variables were summarized as medians and interquartile ranges (IQRs). Groups were compared using exact permutation Mann-Whitney tests and Fisher's exact test, as appropriate.

RESULTS

The simultaneous group required fewer programming visits than the staged group (median 3 [IQR 3-5] vs 7.5 [IQR 6-10], P < 0.001) and had a shorter interval from initial implantation to stable therapy (5.5 [IQR 3-7] vs 14.5 [IQR 12-17] months, P = 0.007). An exploratory comparison of recorded levodopa equivalent dose reduction did not detect a difference between groups (P = 0.905).

CONCLUSIONS

In this small retrospective cohort, simultaneous implantation was associated with fewer programming visits and a shorter overall interval to stable bilateral therapy. The timing difference includes the interval between staged procedures and does not establish superior clinical efficacy or equivalent medication outcomes.