Risk Of Falls In Parkinson'S Disease After Deep Brain Stimulation

OBJECTIVE: To investigate the risk factors associated with falling in patients with Parkinson9s disease (PD) who underwent deep brain stimulation (DBS) as compared to those who received best medical therapy (BMT) in a randomized controlled trial. BACKGROUND: Falls are a major source of morbidity and disability in patients with PD. Although motor function improved significantly with DBS, there were also significantly more events for falls for the DBS group vs BMT group during 6 months of follow-up. Therefore, there is a need to investigate the major risk factors associated with falling after DBS. DESIGN/METHODS: Data from a randomized controlled trial comparing the 6-month outcomes for patients with PD who received DBS vs. BMT were analyzed. Multiple variables for demographics and disease symptoms of the two groups and those of the fallers and nonfallers in the DBS group were compared using statistical univariate and multivariate logistic regression analysis. RESULTS: During the 6 months of follow-up, 41% or 75 of 182 subjects (men=148; mean age=61.8; mean years taking PD medications=10.6) in the DBS group fell as compared to 22 of 134 subjects (16%; men=110; mean age=62.3 years; mean years taking PD medications=12.6) in the BMT group (p CONCLUSIONS: Preventing falls is of paramount importance in the care of patients with PD. A subgroup of patients may be at a higher risk for falls after DBS. Special attention to fall risk using management plans should be implemented to avoid this potentially serious adverse event after an otherwise very beneficial treatment. Supported by: Department of Veterans Affairs, NINDS, and Metronic Neurological. Disclosure: Dr. Lai has received personal compensation from Forest Pharmaceuticals, Allergan, Pfizer, UCB and Novartis Pharmaceuticals for speaking programs and consulting services. Dr. Lai received research support for activities from Medtronic and Allergan. Dr. Bryant has nothing to disclose. Dr. Luo has nothing to disclose. Dr. Follett has nothing to disclose. Dr. Stern has nothing to disclose. Dr. Reda has received personal compensation for activities with Otonomy, Inc. as an advisory board member. Dr. Weaver has nothing to disclose.