Skip to main content
. 2020 Jul 28;10(3):903–910. doi: 10.3233/JPD-202072

Table 1.

Recommendations for DBS device replacement triage during pandemic measures

Consequence of DBS cessation Patient characteristics Scheduling priority
At risk for life-threatening symptoms or hospitalization Parkinson’s disease with DBS-withdrawal syndrome risk factors*; Generalized dystonia; Tourette syndrome with head snapping tics or self-injurious behavior; Depression depending on target+ Highest priority for replacement
Severe symptoms with therapy cessation; may require hospitalization or seek care via emergency services Non-generalized dystonias; Advanced Parkinson’s disease with meaningful DBS benefit; Severe essential tremor without caregivers to assist with activities of daily living; Tourette syndrome with severe tics; Obsessive compulsive disorder; Depression depending on target+; Epilepsy High priority for replacement
Mild to moderate symptoms with therapy cessation; not requiring hospitalization Most essential tremor; Parkinson’s disease, dystonia, OCD, depression or epilepsy with only mild DBS benefit; Mild Tourette syndrome Moderate priority for replacement

*Long-standing STN DBS (>5 years), advanced disease (>15 years), low dopaminergic medications [2, 16]; +Risk for suicidality acuity may depend on anatomical target, with faster decompensation in medial forebrain bundle than subcallosal cingulate [23, 26].