Evidence map›Paper›PMID 30363375›Full record

ReviewMovement disorders clinical practice

Challenges in PD Patient Management After DBS: A Pragmatic Review.

Malco Rossi, Verónica Bruno, Julieta Arena, Ángel Cammarota, Marcelo Merello

Open access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Movement disorders clinical practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 3 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 77 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Malco RossiMovement Disorders Section, Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina.ORCID 0000-0003-3383-8566
Verónica BrunoMovement Disorders Section, Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina.
Julieta ArenaMovement Disorders Section, Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina.
Ángel CammarotaMovement Disorders Section, Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina.
Marcelo MerelloMovement Disorders Section, Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina.ORCID 0000-0001-6898-7823
Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia · ARConsejo Nacional de Investigaciones Científicas y Técnicas · AR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDeep brain stimulation (DBS) of the subthalamic nucleus (STN) or internal globus pallidus (GPi) represents an effective and universally applied therapy for Parkinson's disease (PD) motor complications. However, certain procedure-related problems and unrealistic patient expectations may detract specialists from indicating DBS more widely despite significant clinical effects.

methodsThis review provides a pragmatic educational summary of the most conflicting postoperative management issues in patients undergoing DBS for PD.

resultsDBS in PD has been associated with certain complications and post-procedural management issues, which can complicate surgical outcome interpretation. Many PD patients consider DBS outcomes negative due to unfulfilled expectations, even when significant motor symptom improvement is achieved. Speech, gait, postural stability, and cognition may worsen after DBS and body weight may increase. Although DBS may induce impulse control disorders in some cases, in others, it may actually improve them when dopamine agonist dosage is reduced after surgery. However, apathy may also arise, especially when dopaminergic medication tapering is rapid. Gradual loss of response with time suggests disease progression, rather than the wearing off of DBS effects. Furthermore, implantable pulse generator expiration is considered a movement disorder emergency, as it may worsen parkinsonian symptoms or cause life-threatening akinetic crises due to malignant DBS withdrawal syndrome.

conclusionMajor unsolved issues occurring after DBS therapy preclude complete patient satisfaction. Multidisciplinary management at experienced centers, as well as careful and comprehensive delivery of information to patients, should contribute to make DBS outcome expectations more realistic and allow post procedural complications to be better accepted.

Indexed as

adverse effectsclinical outcomecomplicationsdeep brain stimulationParkinson's disease

Identifiers

PMID30363375
PMCPMC6174419
OpenAlexW2790864605

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.