To evaluate differences in demographics, disease characteristics, quality of life (QOL), and caregiver burden (CB) between deep brain stimulation (DBS) and levodopa-carbidopa intestinal gel (LCIG) users in a large international Parkinson’s disease (PD) cohort.

For patients with advanced PD complicated by motor fluctuations, device-assisted treatments such as DBS and LCIG have been shown to be safe and effective in stabilizing motor symptoms and reducing dyskinesias. However, data are limited comparing patient characteristics and outcomes between DBS and LCIG.

Data were collected from the PF-QII registry, an international multi-center prospective study of PD care and outcomes at expert centers. Utilization rates of DBS and LCIG were compared between U.S. and non-U.S. centers between 2010-2019. Baseline demographics, disease characteristics, exercise patterns, QOL scores, and CB scores were compared between DBS and LCIG users. Longitudinal analyses compared QOL and CB scores over time between DBS and LCIG users.

3842 patients from U.S. and 2232 patients from non-U.S. centers were included in the analysis. Patients in U.S. centers were more likely to receive DBS than those from non-U.S. centers (22.0% vs 14.4%, p<0.0001), while the opposite was true for LCIG (1.4% vs 2.6%, p=0.0009). DBS versus LCIG groups significantly differed in many demographic and disease characteristics: DBS patients were more likely to have a younger age (p<0.0001), no caregiver (p=0.003), Hoehn & Yahr stage 1-2 (p<0.0001), longer hours of vigorous and moderate exercise (p=0.01), better QOL scores (p<0.0001), and better CB scores (p=0.003). Longitudinally, DBS users had a trend toward a greater decline in QOL score (p=0.058) over a year follow up.

Analysis of a large, real-world international registry revealed that DBS users were younger and had less advanced PD compared to LCIG users. DBS users also had better QOL and less CB, but had a trend toward a greater QOL decline over time.