Can DBS Candidacy Be Assessed Online?

In brief

An online consultation can provide a useful preliminary assessment for Parkinson’s patients considering deep brain stimulation abroad.

Medical records, medication response, symptom videos and previous imaging can be reviewed remotely. However, final DBS candidacy generally requires an in-person neurological examination, levodopa assessment, neuropsychological evaluation and surgical review.

What can be assessed online?

The initial consultation may review:

• Confirmation and duration of the Parkinson’s diagnosis

• Current medications and doses

• “On” and “off” periods

• Dyskinesia and medication side effects

• Tremor, rigidity and slowness

• Walking, balance, speech and swallowing

• Previous MRI examinations

• General health and surgical history

• Expectations from DBS

Videos recorded during different medication states may help demonstrate motor fluctuations, but they do not replace a formal examination.

Which documents should be sent?

International patients should ideally prepare:

• Recent neurology reports

• Complete medication schedule

• Brain MRI images rather than only the written report

• Relevant blood tests

• Cardiology or anaesthesia reports when applicable

• Cognitive or psychiatric assessments

• Previous operation reports

• Short symptom videos if requested

Documents should be translated into English or Turkish when the original language cannot be reviewed by the clinical team.

What cannot be completed online?

A remote consultation cannot fully replace:

• Detailed neurological examination

• Standardised “off–on” levodopa testing

• Formal neuropsychological assessment

• Anaesthesia examination

• DBS-specific MRI or CT planning

• Multidisciplinary team review

Neuropsychological testing and levodopa responsiveness are important components of DBS selection.

My approach

I use the online consultation to determine whether travelling for a full DBS assessment appears reasonable and to identify missing information before the patient arrives.

It should be presented as a preliminary review—not as a guarantee that surgery will be recommended.

Frequently asked questions

Can surgery be booked after one video call?

A provisional plan may be discussed, but final approval should follow the required examinations.

Can a family member join the consultation?

Yes. A care partner can provide valuable information about symptoms, cognition and daily function.

Can DBS programming also be performed online?

Remote programming availability depends on the implanted system, local regulations and technical infrastructure.

Conclusion

Online DBS assessment can reduce unnecessary travel and help organise the evaluation process. Final suitability and target selection still require comprehensive clinical assessment.

Dr Kaan Tuğberk ÖzdemirNeurosurgeon – İzmir, Türkiye

This content provides general information and does not confirm individual DBS eligibility.