Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for advanced Parkinson disease (PD) with severe motor fluctuations.1,2 More recently, in a randomized controlled trial of patients with PD with early fluctuating impairment (motor fluctuation onset <3 years), STN DBS was more effective than best medical treatment in improving quality of life (QoL) 2 years after operation.3 Nevertheless, when considering a relatively invasive and costly intervention, the balance between benefits and risks should be carefully weighed. Clinical factors that might be predictive of better outcome after DBS would be helpful in this regard.
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