title: Patients' expectations in subthalamic nucleus deep brain stimulation surgery for Parkinson disease.
abstract: OBJECTIVE
  Subthalamic nucleus (STN) deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson disease. However, some patients feel less satisfied with the outcome of surgery. We sought to study the relationship between expectations, satisfaction, and outcome in STN DBS for Parkinson disease.
  
  
  METHODS
  Twenty-two consecutive patients undergoing STN DBS completed a modified 39-item Parkinson disease questionnaire (PDQ-39) preoperatively and 6 months postoperatively. A satisfaction questionnaire accompanied the postoperative questionnaire.
  
  
  RESULTS
  Patients expected a significant improvement from surgery preoperatively: preoperative score (median PDQ-39 summary score [interquartile range]): 37.0 (9.5), expected postoperative score: 13.0 (8.0), P < 0.001. Patients improved after surgery (preoperative score 39.0 [11.5], postoperative score 25.0 [14.3], P = 0.003), although there was a substantial disparity between the expected change (24.0 [15.0]) and actual change (14.0 [22.5]), P = 0.008. However, most patients felt that surgery fulfilled their expectations (mean score on a 0%-100% visual analog scale); (75.3 ± 17.8) and were satisfied (73.3 ± 25.3). Satisfaction correlated with fulfillment of expectations (r = 0.910, P < 0.001) but not with quantitative changes in PDQ-39 scores.
  
  
  CONCLUSIONS
  Addressing patients' expectations both preoperatively and postoperatively may play an important role in patient satisfaction, and therefore overall success, of STN DBS surgery for Parkinson disease.
authors: Department of Neurosurgery, King's College Hospital, Denmark Hill, London, United Kingdom. Electronic address: h.hasegawa@nhs.net.
authors: Harutomo
authors: H
authors: Hasegawa
authors: Department of Neurology, King's College Hospital, Denmark Hill, London, United Kingdom; Department of Neurology, East Kent Hospitals NHS University Foundation Trust, Canterbury, Kent, United Kingdom.
authors: Michael
authors: M
authors: Samuel
authors: Department of Public Health Sciences, King's College London, London, United Kingdom; NIHR Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, United Kingdom.
authors: Abdel
authors: A
authors: Douiri
authors: Department of Neurosurgery, King's College Hospital, Denmark Hill, London, United Kingdom; Department of Clinical Neurosciences, Institute of Psychiatry, King's College London, London, United Kingdom.
authors: Keyoumars
authors: K
authors: Ashkan
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D017060:Patient Satisfaction; D020531:Subthalamic Nucleus; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Deep brain stimulation; Expectations; Parkinson disease; Satisfaction; Subthalamic nucleus