Retrospective Multicenter Analysis of Withdrawal Syndromes After Stimulator Cessation in Parkinson’s Disease Patients with Deep Brain Stimulation

Background: Abrupt cessation of deep brain stimulation (DBS) in Parkinson’s disease (PD), most commonly due to implantable pulse generator (IPG) depletion, may lead to DBS withdrawal syndrome (DBS-WDS). However, withdrawal does not occur in all patients following stimulation cessation.Methods: We retrospectively analyzed 210 PD patients treated with DBS. Patients with documented stimulation cessation were evaluated for the presence of withdrawal syndrome based on clinical criteria. Demographic, disease-related, and treatment characteristics were assessed, with descriptive analysis of severe cases requiring intensive care.Results: DBS battery shutdown occurred in 28 patients (13.3%). Most patients did not develop withdrawal syndrome and experienced only transient motor worsening. Severe DBS-WDS requiring intensive care was rare, occurring in only three patients (1.4%). Battery shutdown alone did not predict withdrawal, and preoperative levodopa equivalent daily dose was not associated with withdrawal risk.Conclusions: DBS battery shutdown is usually not accompanied by withdrawal syndrome, and severe DBS-WDS is uncommon. Proactive battery management may help prevent this rare but serious complication.