Drs. Eijkholt and Cabrera published in ‘Neuromodulation: Technology at the Neural Interface’

Marleen Eijkholt photoLaura Cabrera photoCenter Assistant Professor Dr. Marleen Eijkholt and Assistant Professor Dr. Laura Cabrera are co-authors of a new article in Neuromodulation: Technology at the Neural Interface. The article, “Shaking Up the Debate: Ensuring the Ethical Use of DBS Intervention Criteria for Mid-Stage Parkinson’s Patients,” was written by Dr. Eijkholt, Dr. Cabrera, Adolfo Ramirez-Zamora, MD (University of Florida), and Julie G. Pilitsis MD, PhD (Albany Medical Center).

Deep brain stimulation (DBS) is a well-established treatment for the management of severe motor fluctuations in advanced Parkinson’s disease (PD). Until recently, device regulation, medical, and insurance practices limited DBS to patients with advanced stages of PD. In February 2016 this changed, however, when the US Food and Drug Administration (FDA) granted formal approval for the use of brain stimulator in mid-stage PD patients. In this article, we examine whether DBS in mid-stage PD can be ethically justified beyond the FDA approval.

Materials and Methods
We scrutinize the current risk-benefit profile, the costs-benefit profile, and the capacity for informed consent requirement, to ask if use of subthalamic nucleus (STN) in mid-stage DBS is ethically appropriate.

We propose that mid-stage DBS decisions could be appropriate under a shared decision-making model, which embraces a broad quality of life perspective.

Although it might be too premature to know how the FDA decision will affect medical and insurance practices, we conclude by arguing that revisions to persisting guidelines seems justified both on scientific and ethical grounds.

The full text is available through Wiley Online Library (MSU Library or other institutional access may be required to view this article).