Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease.

We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-five STN patients and 16 GPi patients were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN, P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with off-stimulation, regardless of the sequence of stimulation. In open assessment, both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN, P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS in advanced PD. Although the surgical targets were not randomized, there was a trend to a better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group.

Moro E ，Lozano AM ，Pollak P ，Agid Y ，Rehncrona S ，Volkmann J ，Kulisevsky J ，Obeso JA ，Albanese A ，Hariz MI ，Quinn NP ，Speelman JD ，Benabid AL ，Fraix V ，Mendes A ，Welter ML ，Houeto JL ，Cornu P ，Dormont D ，Tornqvist AL ，Ekberg R ，Schnitzler A ，Timmermann L ，Wojtecki L ，Gironell A ，Rodriguez-Oroz MC ，Guridi J ，Bentivoglio AR ，Contarino MF ，Romito L ，Scerrati M ，Janssens M ，Lang AE ... -  《-》

Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up.

Rodriguez-Oroz MC ，Obeso JA ，Lang AE ，Houeto JL ，Pollak P ，Rehncrona S ，Kulisevsky J ，Albanese A ，Volkmann J ，Hariz MI ，Quinn NP ，Speelman JD ，Guridi J ，Zamarbide I ，Gironell A ，Molet J ，Pascual-Sedano B ，Pidoux B ，Bonnet AM ，Agid Y ，Xie J ，Benabid AL ，Lozano AM ，Saint-Cyr J ，Romito L ，Contarino MF ，Scerrati M ，Fraix V ，Van Blercom N ... -  《-》

Pallidal vs subthalamic nucleus deep brain stimulation in Parkinson disease.

Anderson VC ，Burchiel KJ ，Hogarth P ，Favre J ，Hammerstad JP ... -  《archives of neurology》

Stimulation of the caudal zona incerta is superior to stimulation of the subthalamic nucleus in improving contralateral parkinsonism.

Plaha P ，Ben-Shlomo Y ，Patel NK ，Gill SS ... -  《-》

Meta-analysis comparing deep brain stimulation of the globus pallidus and subthalamic nucleus to treat advanced Parkinson disease.

Liu Y ，Li W ，Tan C ，Liu X ，Wang X ，Gui Y ，Qin L ，Deng F ，Hu C ，Chen L ... -  《-》