Caregiver burden worsens in the second year after subthalamic nucleus deep brain stimulation for Parkinson's disease

• Published in: Parkinsonism & related disorders 2020-09, Vol.78, p.4-8
• Main Authors: Jackowiak, Eric, Maher, Amanda Cook, Persad, Carol, Kotagal, Vikas, Wyant, Kara, Heston, Amelia, Patil, Parag G., Chou, Kelvin L.
• Format: Article
• Language: English
• Subjects: Caregiver burden; Deep brain stimulation; Parkinson's disease; Subthalamic nucleus
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2020.06.036

Caregiver burden (CB) in Parkinson's disease (PD) does not improve in the short term after bilateral subthalamic nucleus (STN) deep brain stimulation (DBS), despite motor improvement. This may be due to increased caregiver demands after surgery or the possibility that DBS unresponsive non-motor factors, such as executive dysfunction, contribute to CB. To evaluate the trajectory of CB in year 2 following bilateral STN DBS surgery for PD, and to test whether post-operative CB changes correlate with changes in executive function in a subgroup with available neuropsychological testing. This retrospective analysis included 35 patients with PD whose caregivers completed the Caregiver Burden Inventory (CBI) at baseline and between 9 and 24 months after bilateral STN DBS. 14 of these patients had neuropsychological testing both at baseline and within 6 months of their follow up CBI assessment. CBI scores showed worsened CB from baseline to follow-up (16.4–21.5, p = 0.006). There was no correlation between change in executive function and change in CBI in the smaller subsample. CB worsens in the 2 years after bilateral STN DBS despite improvement in motor symptoms and is not associated with change in executive dysfunction in the setting of advancing PD. These findings have implications on pre-operative counselling for patients and caregivers considering DBS for PD. •Scant data exists on long-term effects of DBS on caregiver burden in PD.•We demonstrated that PD caregiver burden worsens in the second year after DBS.•Caregiver burden worsens despite PD motor improvement.•Caregiver burden after DBS does not correlate with executive dysfunction.•Contribution of non-motor symptoms to caregiver burden may explain our findings.