2025 American Academy of Neurology Abstract Website

Objective:

To assess barriers in accessing Deep Brain Stimulation (DBS), as a function of the time required for each step of the workup and how the COVID-19 pandemic affected the timelines for access.

Background:

DBS is an effective and life-changing treatment for people with Parkinson’s disease (PD) in carefully selected patients. One of the major barriers to access is the wait time associated with an interdisciplinary workup process. Extended wait times could contribute to precipitated functional decline leading to loss of eligibility for DBS in addition to the lost time in quality-of-life improvements. We aim to assess access to DBS particularly related to the workup timeline. The second focus is to analyze the impact of COVID-19 pandemic on the DBS evaluation process and patients’ potential functional decline.

Design/Methods:

We set the decision to proceed with DBS as the start of the work-up and analyzed the timelines for implants from 2015 to 2022 at the University of Alberta. Specifically, we analyzed the time required to see other specialists and healthcare allies on the team and the impact COVID-19 had on access.

Results:

The total time from starting the work-up to DBS surgery was 387.76 ± 125.19 days prior to COVID-19, and marked delay occurred during and post-COVID-19 (839.78 ± 240.47 days). Most workups were done within 6 months, although a big range existed due to variable factors. The major delay to surgery was from consent to DBS. Pre-pandemic, no patients lost their candidacy status due to functional/cognitive decline during the work-up process. Further, the system has experienced difficulties in recovery even post-pandemic.

Conclusions:

The impact of COVID-19 on DBS wait times and the consequences related to such have not been well studied in Canada. This study provided a first-hand account and encouraged further study and consideration to optimize access to DBS.