• Gencer Genc, Hesham Abboud, Srivadee Oravivattanakul, Faisal Alsallom, Nicolas R Thompson, Scott Cooper, Michal Gostkowski, Andre Machado, and Hubert H Fernandez.
• Cleveland Clinic, Neurological Institute, Center for Neurological Restoration, Cleveland, OH, USA.
• Neuromodulation. 2016 Jan 1; 19 (1): 25-30.

ObjectivesTo investigate the association between socioeconomic status and deep brain stimulation (DBS) outcomes in Parkinson's disease (PD).Materials And MethodsWe analyzed a cohort of PD patients who underwent DBS from 2007 to 2011, who had Clinical Global Impression Scale-Improvement subscale (CGI-I) scores at approximately one year postsurgery. We also analyzed a subgroup of patients who had pre and postoperative Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II (functional subscale) and European Quality of Life Scale (EQ5D) scores. We performed regression analyses to determine the association between their median household income and their improvement in the MDS-UPDRS Part II, EQ-5D, and CGI-I post-DBS surgery.ResultsWe analyzed 125 PD patients with CGI-I at one year post-DBS, including a subset of 43 patients who had pre- and post-DBS MDS-UPDRS Part II and EQ5D scores at 6 and 12 months. Median income was not significantly associated with the one-year CGI-I, the six-month MDS-UPDRS II, and the six-month and one-year EQ5D score. However, after adjusting for preoperative MDS-UPDRS II score, for every $10,000 increase in household median income, there was a 2.15-point improvement on the MDS-UPDRS II score after one year (95% confidence interval = -3.63 to -0.66, p = 0.0060).ConclusionsPD patients with higher household incomes had better functional improvement at one year. However, this did not necessarily translate to better quality of life or overall clinical improvement when compared with PD patients with lower household incomes. The influence of household income on DBS and other advanced therapies for PD will need further investigation.© 2015 International Neuromodulation Society.

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