Pallidal vs subthalamic nucleus deep brain stimulation in Parkinson’s disease
Anderson VC, Burchiel KJ, Hogarth P, Favre J, Hammerstad JP Pallidal vs subthalamic nucleus deep brain stimulation in Parkinson’s disease , 2005 Apr;62(4):554-60
These authors begin by citing studies supporting the safety and efficacy of DBS in the STN and globus pallidus interna (GPi). They wanted to evaluate if DBS of the STN or GPi would be better in improving symptoms of PD. Twenty three patients were randomized (11 GPi; mean age 54, symptom duration 10.3 years and 12 STN; mean age 61, symptom duration 15.6 years), all were taking antiParkinson medications prior to surgery. There was a significant difference between symptom duration between the groups. 3 patients had complications (1 death unrelated to PD, 1 severe PD progression, and 1 intraoperative stroke with residual deficits) excluding them from additional analysis. They found improvement in baseline rigidity, bradykinesia, tremor, activities of daily living, and axial symptoms (speech, gait, posture, and postural stability) after 12 months for both DBS groups. It was notable that there was more improvement with DBS STN in bradykinesia as well as a greater reduction in levodopa as compared to DBS GPi. The authors also discuss all of the complications experienced with both groups. It is notable that they only found cognitive and behavioral complications in the DBS STN group, although both groups experienced medical complications.