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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(07): s00451809996
DOI: 10.1055/s-0045-1809996
Review Article

The costs and benefits of deep brain stimulation in Parkinson's disease: a review and social network analysis

Carlos Zúñiga-Ramírez 
1   Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Unidad de Movimientos Anormales y Enfermedades Neurodegenerativas, Guadalajara, Mexico.
,
Katia Carmina Farías-Moreno 
1   Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Unidad de Movimientos Anormales y Enfermedades Neurodegenerativas, Guadalajara, Mexico.
,
Gabriel Moreno 
2   University of Central Florida-Hospital Corporation of America Florida Healthcare, Department of Neurology, Orlando FL, United States.
,
Enrique Gómez-Figueroa 
3   Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Departamento de Neurología, Guadalajara, Mexico.
,
Hernando Efraín Caicedo-Ortíz 
4   Universidad Anahuac, Ciudad de México, Mexico.
5   Universidad Autónoma de la Ciudad de México, Ciudad de México, Mexico.
,
José Damián Carrillo-Ruíz 
6   Universidad Anahuac, Facultad de Psicología, Coordinación de Neurociencias, Ciudad de México, Mexico.
7   Hospital General de México, Departamento de Neurocirugía Estereotáctica y Funcional, Ciudad de México, Mexico.
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Abstract

Background

Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder worldwide. Levodopa has been considered the best treatment option. However, deep brain stimulation (DBS) use has increased over time, mostly when levodopa-related complications arise.

Objective

To review the current evidence regarding economic evaluations assessing costs and benefits comparing pharmacological versus surgical treatment among subjects with PD.

Methods

We searched three databases (PubMed, Embase, and Google Scholar) for studies comparing levodopa treatment and DBS among subjects with PD in terms of costs and benefits from therapy.

Results

Out of the 107 studies identified, 14 met the inclusion criteria. Most of the published studies were from Europe. Incremental cost-effectiveness ratios have shown variable results, from -€979 to €6,729 per change of 1 point in the score on part III of the Unified Parkinson's Disease Rating Scale (UPDRS III), while incremental cost-utility ratios depict values as low as €6,700 and as high as $704,906.03 per quality-adjusted life-years (QALY).

Conclusion

We observed a higher cost during the 1st year of DBS implantation due to the surgical procedure itself, subsequently, there was a trend for a lower cost over the following years, with no loss of benefit. Overall, the studies showed DBS as a cost-effective measure at 5-years after implantation.

Keywords

Parkinson Disease - Levodopa - Deep Brain Stimulation - Cost-Effectiveness Analysis - Cost-Benefit Analysis

Authors' Contributions

CZR: conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing – original draft, and writing – review & editing; HECO: conceptualization, data curation, formal analysis, methodology, project administration, software, supervision, validation, and visualization; JDCR: conceptualization, investigation, methodology, supervision, validation, and visualization; KCFM: data curation, formal analysis, investigation, methodology, project administration, software, supervision, and validation; GM: data curation, formal analysis, investigation, supervision, and visualization; and RGF: formal analysis, investigation, methodology, supervision, validation, and visualization.


Data Availability Statement

No new data were generated or analyzed in the present study.


Editor-in-Chief: Hélio A. G. Teive (https://orcid.org/0000-0003-2305-1073).


Associate Editor: Renato Puppi Munhoz (https://orcid.org/0000-0002-4783-4067).




Publikationsverlauf

Eingereicht: 06. März 2025

Angenommen: 06. Mai 2025

Artikel online veröffentlicht:
17. Juli 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Carlos Zúñiga-Ramírez, Katia Carmina Farías-Moreno, Gabriel Moreno, Enrique Gómez-Figueroa, Hernando Efraín Caicedo-Ortíz, José Damián Carrillo-Ruíz. The costs and benefits of deep brain stimulation in Parkinson's disease: a review and social network analysis. Arq Neuropsiquiatr 2025; 83: s00451809996.
DOI: 10.1055/s-0045-1809996