A Real Data-Driven, Robust Survival Analysis on Patients who Underwent Deep Brain Stimulation for Parkinson's Disease by Utilizing Parametric, Non-Parametric, and Semi-Parametric Approaches

TL;DR

This study applies advanced statistical survival analysis methods to long-term data of Parkinson's Disease patients treated with Deep Brain Stimulation, revealing gender differences and prognostic factors affecting survival outcomes.

Contribution

It introduces a comprehensive application of non-parametric, semi-parametric, and robust parametric survival models to analyze DBS outcomes in PD patients, highlighting gender-specific survival distributions and prognostic factors.

Findings

Female patients have higher survival rates than males.

Survival times follow distinct distributions: Lognormal for females, Weibull for males.

Initial implant side and number of revisions influence event frequency and prognosis.

Abstract

Parkinson's Disease (PD) is a devastating neurodegenerative disorder that affects millions of people around the globe. Many researchers are continuously working to understand PD and develop treatments to improve the condition of PD patients, which affects their day-to-day lives. Since the last decades, the treatment, Deep Brain Stimulation (DBS) has given promising results for motor symptoms by improving the quality of daily living of PD patients. In the methodology of the present study, we have utilized sophisticated statistical approaches such as Nonparametric, Semi-parametric, and robust Parametric survival analysis to extract useful and important information about the long-term survival outcomes of the patients who underwent DBS for PD. Finally, we were able to conclude that the probabilistic behavior of the survival time of female patients is statistically different from that of male patients. Furthermore, we have identified that the probabilistic behavior of the survival times of Female patients is characterized by the 3-parameter Lognormal distribution, while that of Male patients is characterized by the 3-parameter Weibull distribution. More importantly, we have found that the Female patients have higher survival compared to the Male patients after conducting a robust parametric survival analysis. Using the semi-parametric COX-PH, we found that the initial implant of the right side leads to a high frequency of events occurring for the female patients with a bad prognostic factor, while for the male patients, a low events occurs with a good prognostic factor. Furthermore, we have found an interaction term between the number of revisions and the initial size of the implant, which increases the frequency of events occurring for the Male patients with a bad prognostic factor.