title: Insights gleaned by measuring patients' stated goals for DBS: More than tremor.
abstract: OBJECTIVE
  To report prospective repeated measures data detailing the perceived benefit of deep brain stimulation (DBS) on the most commonly cited symptom and activity goals identified by patients with Parkinson disease.
  
  
  METHODS
  Fifty-two participants were recruited from a consecutive series. Participants completed a semi-structured interview soliciting their symptom and behavioral goals and corresponding visual analog scales measuring perceived symptom severity and limits to goal attainment. Severity ratings were completed prior to and at 2 times following DBS. Changes in severity over time were assessed using a mixed effects linear model. The pattern of relationships between the severity ratings and standard clinical research (SCR) measures routinely administered were examined using Pearson correlations.
  
  
  RESULTS
  The most common symptom goals were improvements in tremor, gait, and nonmotor symptoms, whereas the most frequent behavioral goals related to interpersonal relationships, work, and avocational pursuits. Most severity ratings were significantly correlated with each other but not with the SCR measures. Significant improvements were evident on all SCR measures after DBS. Participants' severity ratings for their symptom and behavioral goals improved significantly over time although not all severity ratings changed in the same manner.
  
  
  CONCLUSIONS
  These data illustrate that improvements in participants' individually defined goals were evident over time and that some of these improvements occurred in areas in which the benefits associated with DBS are not as well-documented. The participants' severity ratings were not redundant with SCR measures, suggesting that novel and potentially important information can be gleaned by systematically assessing patients' goals.
authors.affiliation: From the Center for Neurological Restoration (C.S.K., A.M.), Center for Pediatric Behavioral Health (T.F.), and NeuroEthics Program (P.J.F.), Cleveland Clinic, OH; and Department of Neurology (S.E.C., J.V.), University of Minnesota, Minneapolis. kubuc@ccf.org.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Kubu
authors.affiliation: From the Center for Neurological Restoration (C.S.K., A.M.), Center for Pediatric Behavioral Health (T.F.), and NeuroEthics Program (P.J.F.), Cleveland Clinic, OH; and Department of Neurology (S.E.C., J.V.), University of Minnesota, Minneapolis.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Cooper
authors.affiliation: From the Center for Neurological Restoration (C.S.K., A.M.), Center for Pediatric Behavioral Health (T.F.), and NeuroEthics Program (P.J.F.), Cleveland Clinic, OH; and Department of Neurology (S.E.C., J.V.), University of Minnesota, Minneapolis.
authors.forename: Andre
authors.initials: A
authors.lastname: Machado
authors.affiliation: From the Center for Neurological Restoration (C.S.K., A.M.), Center for Pediatric Behavioral Health (T.F.), and NeuroEthics Program (P.J.F.), Cleveland Clinic, OH; and Department of Neurology (S.E.C., J.V.), University of Minnesota, Minneapolis.
authors.forename: Thomas
authors.initials: T
authors.lastname: Frazier
authors.affiliation: From the Center for Neurological Restoration (C.S.K., A.M.), Center for Pediatric Behavioral Health (T.F.), and NeuroEthics Program (P.J.F.), Cleveland Clinic, OH; and Department of Neurology (S.E.C., J.V.), University of Minnesota, Minneapolis.
authors.forename: Jerrold
authors.initials: J
authors.lastname: Vitek
authors.affiliation: From the Center for Neurological Restoration (C.S.K., A.M.), Center for Pediatric Behavioral Health (T.F.), and NeuroEthics Program (P.J.F.), Cleveland Clinic, OH; and Department of Neurology (S.E.C., J.V.), University of Minnesota, Minneapolis.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Ford
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods* / Q000523:psychology; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014202:Tremor / Q000209:etiology / Q000628:therapy; D064232:Visual Analog Scale