Survey of U.S. neurologists' attitudes towards deep brain stimulation for Parkinson's disease.

ABSTRACT

OBJECTIVES: Deep brain stimulation (DBS) for Parkinson's disease (PD) was approved by the Food and Drug Administration in 2002 and has demonstrated clinical benefit in advanced PD. Our aim was to assess attitudes of U.S. neurologists towards the role of DBS in management of advanced PD. MATERIALS AND METHODS: We sent a 40-item Internet-based survey assessing opinions regarding the role of medical and surgical therapies in managing PD to 7722 neurologists in the American Medical Association Physician MasterFile data base. RESULTS: The response rate was low (4.2%). In total, 78 of the 298 (26%) responders self-identified as movement disorders specialists. Specialists and non-specialists had differences on a number of medical strategies used to manage PD. There were no statistically significant differences in reasons for or against referring patients for DBS, except for the number of non-specialists who agreed with referring a patient who had a "poor or absent response to levodopa" (71% vs. 16%, p < 0.001). Both groups indicated a need for more information concerning appropriate indications for DBS, adverse effects of surgery, and postoperative programming. CONCLUSIONS: Movement disorders specialists and non-specialists were in general agreement towards the beneficial role of DBS in management of advanced PD except for whether to refer patients with poor or absent response to levodopa.