Importance of Education, Clinical Examination Before Deep Brain Stimulation: Nasrin Esnaashari, CNS, NPC, DNP


The nurse practitioner at the University of Southern California Keck Medical School provided insight on steps before deep brain stimulation and how they can impact outcomes for patients with Parkinson disease. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

"We confirm that DBS education along the way, before, during and through the period the patient leaves, is an absolutely important tool we can use in clinic to keep our patients within the realm of reality."

Approved for more than 2 decades, deep brain stimulation (DBS) is a surgical approach used to treat certain aspects of Parkinson disease (PD), including the movement symptoms and adverse events caused by medications. Several publications have examined the outcome of DBS for PD, but none have assessed patient satisfaction and fulfillment of patients’ experience. Presented at the 2nd Annual Advanced Therapeutics in Movement and Related Disorders (ATMRD) Congress, held by the PMD Alliance from June 8 to 11, 2023, in Washington, DC, a study determined patients expectations to DBS preoperatively, evaluated their fulfillment postoperatively, and correlated this with their self-rated motor improvement and with clinical evaluations.

Led by Nasrin Esnaashari, CNS, NPC, DNP, 20 patients with 24-month data completed a questionnaire recording 3 goals for DBS before their operation. These goals were sorted into 1 of 13 categories previously formulated from initial observations. At the conclusion of the analysis period, all patients reported improvement in their neurologic symptoms, but the extent of the improvement did not correlate with Clinical Global Impression-Improvement scores. In addition, the 2 individual goals that were major components of overall patient satisfaction were: reduce tremor, and reduce medications.

Esnaashari, nurse practitioner at the University of Southern California Keck School of Medicine, believes these findings highlight the importance of education prior to DBS, furthering better overall outcomes and patient satisfaction. At the meeting, NeurologyLive® sat down with Esnaashari to discuss patient expectations and how they stack up to clinical outcomes of DBS, as well as why engaging conversations can lead to better long-term quality of life.

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