Effect of deep brain stimulation on caregivers of patients with Parkinson's disease: a systematic review

Hienen, M.M. van; Contarino, M.F.; Middelkoop, H.A.M.; Hilten, J.J. van; Geraedts, V.J. (2020)

Article / Letter to editor

Background: Caregivers of patients with Parkinson's Disease (PD) often provide important support in the preand postoperative phase of Deep Brain Stimulation (DBS). DBS-associated changes of patient-functioning may affect caregiver wellbeing and impact the support system. Factors influencing caregiver-wellbeing under these circumstances are incompletely known.Objective: to systematically review studies of sufficient methodological quality on the impact of DBS on caregivers of PD patients.Methods: using PRISMA guidelines, major databases were searched up to May 2020. Five subcategories were identified: Caregiver burden, Caregiver cognitive and psychiatric functioning, Caregiver Quality of Life (QoL), Marital Satisfaction/Conflicts, and Caregiver Satisfaction. Quality was assessed using an in-house checklist.Results: 293 studies were identified; 12 were ultimately included. Caregiver burden, psychiatric and cognitive functioning and QoL remained relatively unchanged. Results on marital satisfaction/conflicts were contrasting: an increase in marital conflicts despite improved relationship quality scores DBS. Caregiver satisfaction with surgery was low with 50-58% of caregivers being disappointed with DBS outcomes. Concerning caregiver related factors: a higher preoperative caregiver QoL, younger age, lower scores on psychiatric rating scales, and more favourable preoperative relationship quality scores, were associated with better caregiver wellbeing. A favourable patient-profile includes younger age and age-at-onset, shorter disease duration, lower medication requirements, and lower scores on psychiatric rating scales.Conclusion: Although most patient- and caregiver-related subdomains remained unchanged after DBS, dissatisfaction among caregivers and marital problems may constitute a large risk for a well-functioning patient-caregiver dyad. Early recognition of potential problem situations may improve post-DBS care for both patients and caregivers.

• Parkinson's disease
• Deep brain stimulation
• Caregiver
• Quality of life

• All authors: Hienen, M.M. van; Contarino, M.F.; Middelkoop, H.A.M.; Hilten, J.J. van; Geraedts, V.J.
• Date: 2020-12-01
• Journal: Parkinsonism & Related Disorders
• Volume: 81
• Pages: 20 - 27
• DOI: doi:10.1016/j.parkreldis.2020.09.038
• Link: https://www.sciencedirect.com/science/article/pii/S1353802020307707?via%...