Bibliographic Details
| Title: |
Deep brain stimulation of globus pallidus internus and subthalamic nucleus in Parkinson's disease: a multicenter, retrospective study of efficacy and safety. |
| Authors: |
Mainardi, Michele, Ciprietti, Dario, Pilleri, Manuela, Bonato, Giulia, Weis, Luca, Cianci, Valeria, Biundo, Roberta, Ferreri, Florinda, Piacentino, Massimo, Landi, Andrea, Guerra, Andrea, Antonini, Angelo |
| Source: |
Neurological Sciences; Jan2024, Vol. 45 Issue 1, p177-185, 9p |
| Subject Terms: |
DEEP brain stimulation, BRAIN stimulation, PARKINSON'S disease, GLOBUS pallidus, SUBTHALAMIC nucleus |
| Abstract: |
Background: Deep brain stimulation (DBS) is an established therapeutic option in advanced Parkinson's disease (PD). Literature data and recent guidelines remain inconclusive about the best choice as a target between the subthalamic nucleus (STN) and the globus pallidus internus (GPi). Materials and methods: We retrospectively reviewed the clinical efficacy outcomes of 48 DBS-implanted patients (33 STN-DBS and 15 GPi-DBS) at a short- (<1 year from the surgery) and long-term (2–5 years) follow-up. Also, clinical safety outcomes, including postoperative surgical complications and severe side effects, were collected. Results: We found no difference between STN-DBS and GPi-DBS in improving motor symptoms at short-term evaluation. However, STN-DBS achieved a more prominent reduction in oral therapy (l-dopa equivalent daily dose, P =.02). By contrast, GPi-DBS was superior in ameliorating motor fluctuations and dyskinesia (MDS-UPDRS IV, P <.001) as well as motor experiences of daily living (MDS-UPDRS II, P =.03). The greater efficacy of GPi-DBS on motor fluctuations and experiences of daily living was also present at the long-term follow-up. We observed five serious adverse events, including two suicides, all among STN-DBS patients. Conclusion: Both STN-DBS and GPi-DBS are effective in improving motor symptoms severity and complications, but GPi-DBS has a greater impact on motor fluctuations and motor experiences of daily living. These results suggest that the two targets should be considered equivalent in motor efficacy, with GPi-DBS as a valuable option in patients with prominent motor complications. The occurrence of suicides in STN-treated patients claims further attention in target selection. [ABSTRACT FROM AUTHOR] |
|
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Complementary Index |
|
Full text is not displayed to guests. |
Login for full access.
|
