Peri-lead edema observed in 9.9% of Parkinson's patients undergoing deep brain stimulation surgery.

This retrospective case-control study examined 121 patients with Parkinson's disease who underwent deep brain stimulation surgery at a single center. The primary objective was to assess the occurrence of symptomatic peri-lead edema, while secondary outcomes included edema severity, perioperative oxygenation metrics, obstructive sleep apnea prevalence, and REM sleep behavior disorder incidence.

Symptomatic peri-lead edema was identified in 12 of 121 patients (9.9%). The onset of these symptoms occurred an average of 3.5 days postoperatively, with a reported range of 2 to 9 days. Among patients experiencing peri-lead edema, obstructive sleep apnea prevalence was 75%, significantly higher than the 30% observed in patients without edema (p = 0.002).

Physiological differences were noted between the two groups. The peri-lead edema group exhibited lower perioperative SpO2 (p < 0.05) and lower perioperative PaO2 in the PACU (p = 0.037) compared to the non-edema group. Additionally, RBD incidence was lower in the edema group (20%) versus the non-edema group (60%) within the polysomnography subgroup (unadjusted p = 0.048). A significant positive correlation was found between edema severity and sleep-related hypoxemia indices, alongside a positive association between RBDSQ scores and edema density (rho = 0.86, p = 0.024).

The study is limited by its retrospective design and the availability of polysomnography data in only 26 patients. No serious adverse events or discontinuations were reported. Clinicians should interpret these findings with caution, noting that the observational nature of the study precludes definitive causal conclusions regarding the relationship between edema and respiratory or sleep outcomes.