Subthalamic deep brain stimulation is an advanced therapy that typically improves quality of life for persons with Parkinson’s disease (PD). However, the effect on caregiver burden is unclear. We recruited 64 persons with PD and their caregivers from a movement disorders clinic during the assessment of eligibility for subthalamic DBS. We used clinician-, patient- and caregiver-rated instruments to follow the patient–caregiver dyad from pre- to postoperative status, sampling repeatedly in the postoperative period to ascertain fluctuations in phenotypic variables. We employed multivariate models to identify key drivers of burden. We clustered caregiver-rated variables into ‘high’ and ‘low’ symptom groups and examined whether postoperative cluster assignment could be predicted from baseline values. Psychiatric symptoms in the postoperative period made a substantial contribution to longitudinal caregiver burden. The development of stimulation-dependent mood changes was also associated with increased burden. However, caregiver burden and caregiver-rated psychiatric symptom clusters were temporally stable and thus predicted only by their baseline values. We confirmed this finding using frequentist and Bayesian statistics, concluding that in our sample, subthalamic DBS for PD did not significantly influence caregiver burden or caregiver-rated psychiatric symptoms. Specifically, patient–caregiver dyads with high burden and high levels of psychiatric symptoms at baseline were likely to maintain this profile during follow-up. These findings support the importance of assessing caregiver burden prior to functional neurosurgery. Furthermore, they suggest that interventions addressing caregiver burden in this population should target those with greater symptomatology at baseline and may usefully prioritise psychiatric symptoms reported by the caregiver.

丘脑深部脑刺激是一种先进的疗法，通常可以改善帕金森氏病（PD）患者的生活质量。但是，对照料者负担的影响尚不清楚。在评估丘脑底DBS的资格时，我们从运动障碍诊所招募了64名PD及其护理人员。我们使用了由临床医师，患者和护理人员评估的仪器，从患者术前到术后追踪患者-护理人员的二分法，并在术后期间反复采样以确定表型变量的波动。我们采用多元模型来确定负担的主要驱动因素。我们将照顾者评分的变量归类为“高”和“低”症状组，并检查是否可以从基线值预测术后聚类分配。术后的精神症状对纵向看护者的负担做出了重要贡献。刺激依赖性情绪变化的发展也与负担增加有关。但是，看护者的负担和看护者评定的精神症状群在时间上是稳定的，因此只能通过其基线值进行预测。我们使用频度和贝叶斯统计方法证实了这一发现，并得出结论，在我们的样本中，丘脑下PD的DBS不会显着影响护理人员的负担或护理人员所评定的精神症状。具体而言，在基线时具有高负担和较高精神症状的患者-护理者二联体可能会在随访期间保持这一特征。这些发现支持在功能性神经外科手术之前评估护理人员负担的重要性。此外，