How long does deep brain stimulation give patients benefit? A scoping review

Introduction: Since the advent of Deep Brain Stimulation (DBS) in 1987, one prevailing question has been- what long will patients benefit? Here we performed a scoping review to define longevity of the therapy in different disease states and longevity of device components and techniques to augment battery life.

Methods: The authors performed a MEDLINE search inclusive of articles from 1987 to June 2023 including human and modeling studies written in English. For longevity of therapy studies, only studies with a mean follow up of 3 years or more were included. Using the Rayyan platform, two reviewers (J.P. and R.M.) performed a title screen. Of the 731 articles, 202 were selected by title screen and 110 from abstract review. Ultimately after references from the manuscripts identified were assessed a total of 135 articles were reviewed. The research questions we explore are: 1) how long do device components last? and 2) how long does DBS therapy last in Parkinson’s Disease (a), essential tremor (b), dystonia (c), and other disorders (d)?

Results: We demonstrate that patients with Parkinson’s Disease, Essential Tremor (ET), and dystonia all demonstrate considerable long term benefit in motor and quality of life scores 7 to 10 years after implant. Mobility and disease OFF stimulation worsen showing continued disease progression. Battery life varies by the disease treated and the programming settings used. Higher amplitudes and longer pulse widths are associated with shorter duration while cycling and turning the device off (in ET) is associated with longer battery life.

Conclusion : Here we are able to provide data to health care teams caring for DBS patients on what to expect from their devices as their disease progresses and describe techniques to minimize battery revision/recharging. Outcomes data after 10 years of therapy is a gap in the literature.