
Deep Brain Stimulation Effective Long Term in Improving Motor Function in Parkinson Disease
In comparing the efficacy of deep brain stimulation of the subthalmic nucleus and globus pallidus, both approaches were similarly effective in improving motor function in people with Parkinson disease, with benefits maintained after 10 years.
Deep brain stimulation (DBS) of the subthalmic nucleus (STN) and globus pallidus (GPi) provided significant short-term and long-term improvement in motor function for people with
In prior research, DBS has been associated with a myriad of benefits for patients with PD, ranging from
Examining the
“There are no published studies from prospective randomized trials examining outcomes beyond 3 years comparing STN to GPi DBS,” said the study authors.
They derived patient data from the
Baseline characteristics were cited as comparable, with participants of the STN-DBS and GPi-DBS groups assessed for the primary outcome of change in Unified Parkinson’s Disease Rating Scale (UPDRS) motor subscale in the
Compared with baseline, at which the score was 43.2, motor function was significantly improved and maintained at each completed visit for both the GPi-DBS group (2 years, 25.8; P < .001; 7 years, 35.4; P < .001; 10 years, 34.0; P = .10) and STN-DBS group (2 years, 27.7, P < .001; 7 years, 34.4; P < .001; 10 years, 28.3; P < .001), respectively.
Furthermore, the authors noted that improvements were generally similar between both groups over time, but with a trend favoring STN-DBS (P = .09).
Based on subscales of motor symptoms, tremor showed the greatest reduction over time followed by rigidity, with bradykinesia subscores also showing greater improvement at 7 and 10 years with STN-DBS (P = .03).
UPDRS I, II, and IV scores and quality of time based on motor diaries exhibited significant long-term improvement regardless of group.
Conversely,
Speaking on the study findings, the researchers called it “remarkable” considering the progressive nature of PD. “This is the longest follow up describing DBS outcomes comparing the 2 targets in a randomized cohort,” they concluded.
Reference
Ostrem J, Weaver F, Follett K, et al. 10 year clinical outcomes of subthalamic nucleus versus pallidal deep brain stimulation for Parkinson’s disease: VA/NINDS CSP #468F. Presented at: The American Academy of Neurology’s 73rd Annual Meeting; April 17-22, 2020.
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