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Deep brain stimulation (DBS) is an elective neurosurgical treatment for patients with advanced Parkinson's disease (PD) who suffer from symptoms refractory to medication. DBS requires an invasive procedure in which, first, brain electrodes are implanted while the patient is awake and, second, neurostimulators are implanted under general anesthesia. The neurostimulator batteries require monitoring by specialists and replacement up to every 5 years. Sudden battery depletion could be lifethreatening for patients living with chronic DBS. Additional hardware complications that can occur and that require additional surgery include replacing defective wires or revising skin areas that have eroded. These potential long-term complications can involve ethical choices and challenges for the patient, the surrogate, and treating clinicians.

Pre-existing dementia is currently considered an exclusion criterion for DBS surgery …