Long-term infective complications of deep brain stimulation in Parkinson’s disease: A 22-year follow-up
Introduction: Deep brain stimulation (DBS) is an established treatment for Parkinson’s disease (PD), but infections remain a significant concern. This study evaluated infection rates and their impact in PD patients who underwent subthalamic nucleus (STN)-DBS over a 23-year period. Methods: A total o...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Clinical Parkinsonism & Related Disorders |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590112525000398 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849312708667637760 |
|---|---|
| author | Riccardo Antonio Ricciuti Matteo Maria Ottaviani Fabrizio Mancini Valentina Liverotti Daniele Marruzzo Massimo Marano Francesca Barbieri Riccardo Paracino Serena Pagano Vincenzo Di Lazzaro Mauro Dobran |
| author_facet | Riccardo Antonio Ricciuti Matteo Maria Ottaviani Fabrizio Mancini Valentina Liverotti Daniele Marruzzo Massimo Marano Francesca Barbieri Riccardo Paracino Serena Pagano Vincenzo Di Lazzaro Mauro Dobran |
| author_sort | Riccardo Antonio Ricciuti |
| collection | DOAJ |
| description | Introduction: Deep brain stimulation (DBS) is an established treatment for Parkinson’s disease (PD), but infections remain a significant concern. This study evaluated infection rates and their impact in PD patients who underwent subthalamic nucleus (STN)-DBS over a 23-year period. Methods: A total of 172 PD patients who underwent bilateral STN-DBS between 2000 and 2023 were included in this retrospective study. Patients were followed up for periods ranging from 5 to 22 years, with regular assessments conducted to monitor both clinical outcomes and the occurrence of infections. The study analyzed the timing of infections onset, clinical features, microbiological data, management and outcomes. Results: The overall infection rate was 8.7 % over the follow-up period (15/172). Most of the infections (63.6 %) involved the implantable pulse generator (IPG) subcutaneous pocket, developed after a median of 22 months and were related to the number of substitutions with a notable peak in incidence after the third replacement (3.3 ± 1.5). All the infected devices were non-rechargeable and Staphylococcus epidermidis was the isolated pathogen in all cases except by one. Surgical revision of the IPG pocket was necessary in 46.2 % of cases while all the others were treated by antibiotics. Factors that significantly correlated with infections were the years elapsed since DBS implantation, BMI decrease, and the number of IPG replacements. Conclusions: While STN-DBS remains effective for PD, infection risk rises with time, particularly during IPG replacements. Long-term follow-up and timely management are vital for sustaining therapeutic benefits. |
| format | Article |
| id | doaj-art-1f7db95f09634c8296df627c3e6b4d37 |
| institution | Kabale University |
| issn | 2590-1125 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Parkinsonism & Related Disorders |
| spelling | doaj-art-1f7db95f09634c8296df627c3e6b4d372025-08-20T03:53:01ZengElsevierClinical Parkinsonism & Related Disorders2590-11252025-01-011210033510.1016/j.prdoa.2025.100335Long-term infective complications of deep brain stimulation in Parkinson’s disease: A 22-year follow-upRiccardo Antonio Ricciuti0Matteo Maria Ottaviani1Fabrizio Mancini2Valentina Liverotti3Daniele Marruzzo4Massimo Marano5Francesca Barbieri6Riccardo Paracino7Serena Pagano8Vincenzo Di Lazzaro9Mauro Dobran10Department of Neurosurgery, Azienda San Camillo Forlanini, Rome, Italy; Department of Neurosurgery, Belcolle Hospital, Viterbo, ItalyDepartment of Neurosurgery, Università Politecnica delle Marche, Ancona, Italy; Department of Neurosurgery, Azienda Ospedaliera di Perugia, Perugia, Italy; Corresponding author at: Department of Neurosurgery, Università Politecnica delle Marche, Via Conca 71, Ancona, Italy.Department of Neurosurgery, Azienda Ospedaliera di Perugia, Perugia, ItalyDepartment of Neurosurgery, Università Politecnica delle Marche, Ancona, ItalyDepartment of Neurosurgery, Belcolle Hospital, Viterbo, ItalyUnit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy; Fondazione Policlinico Universitario Campus Bio-Medico, Viale Alvaro del Portillo 200, 00128, Roma, ItalyDepartment of Neurosurgery, Belcolle Hospital, Viterbo, ItalyDepartment of Neurosurgery, Azienda Ospedaliera di Perugia, Perugia, ItalyDepartment of Neurosurgery, Belcolle Hospital, Viterbo, ItalyUnit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy; Fondazione Policlinico Universitario Campus Bio-Medico, Viale Alvaro del Portillo 200, 00128, Roma, ItalyDepartment of Neurosurgery, Università Politecnica delle Marche, Ancona, ItalyIntroduction: Deep brain stimulation (DBS) is an established treatment for Parkinson’s disease (PD), but infections remain a significant concern. This study evaluated infection rates and their impact in PD patients who underwent subthalamic nucleus (STN)-DBS over a 23-year period. Methods: A total of 172 PD patients who underwent bilateral STN-DBS between 2000 and 2023 were included in this retrospective study. Patients were followed up for periods ranging from 5 to 22 years, with regular assessments conducted to monitor both clinical outcomes and the occurrence of infections. The study analyzed the timing of infections onset, clinical features, microbiological data, management and outcomes. Results: The overall infection rate was 8.7 % over the follow-up period (15/172). Most of the infections (63.6 %) involved the implantable pulse generator (IPG) subcutaneous pocket, developed after a median of 22 months and were related to the number of substitutions with a notable peak in incidence after the third replacement (3.3 ± 1.5). All the infected devices were non-rechargeable and Staphylococcus epidermidis was the isolated pathogen in all cases except by one. Surgical revision of the IPG pocket was necessary in 46.2 % of cases while all the others were treated by antibiotics. Factors that significantly correlated with infections were the years elapsed since DBS implantation, BMI decrease, and the number of IPG replacements. Conclusions: While STN-DBS remains effective for PD, infection risk rises with time, particularly during IPG replacements. Long-term follow-up and timely management are vital for sustaining therapeutic benefits.http://www.sciencedirect.com/science/article/pii/S2590112525000398Deep brain stimulationParkinson’s diseaseInfection |
| spellingShingle | Riccardo Antonio Ricciuti Matteo Maria Ottaviani Fabrizio Mancini Valentina Liverotti Daniele Marruzzo Massimo Marano Francesca Barbieri Riccardo Paracino Serena Pagano Vincenzo Di Lazzaro Mauro Dobran Long-term infective complications of deep brain stimulation in Parkinson’s disease: A 22-year follow-up Clinical Parkinsonism & Related Disorders Deep brain stimulation Parkinson’s disease Infection |
| title | Long-term infective complications of deep brain stimulation in Parkinson’s disease: A 22-year follow-up |
| title_full | Long-term infective complications of deep brain stimulation in Parkinson’s disease: A 22-year follow-up |
| title_fullStr | Long-term infective complications of deep brain stimulation in Parkinson’s disease: A 22-year follow-up |
| title_full_unstemmed | Long-term infective complications of deep brain stimulation in Parkinson’s disease: A 22-year follow-up |
| title_short | Long-term infective complications of deep brain stimulation in Parkinson’s disease: A 22-year follow-up |
| title_sort | long term infective complications of deep brain stimulation in parkinson s disease a 22 year follow up |
| topic | Deep brain stimulation Parkinson’s disease Infection |
| url | http://www.sciencedirect.com/science/article/pii/S2590112525000398 |
| work_keys_str_mv | AT riccardoantonioricciuti longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT matteomariaottaviani longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT fabriziomancini longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT valentinaliverotti longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT danielemarruzzo longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT massimomarano longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT francescabarbieri longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT riccardoparacino longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT serenapagano longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT vincenzodilazzaro longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup AT maurodobran longterminfectivecomplicationsofdeepbrainstimulationinparkinsonsdiseasea22yearfollowup |