Academic Journal
Deep brain stimulation of globus pallidus internus and subthalamic nucleus in Parkinson’s disease: a multicenter, retrospective study of efficacy and safety
| العنوان: | Deep brain stimulation of globus pallidus internus and subthalamic nucleus in Parkinson’s disease: a multicenter, retrospective study of efficacy and safety |
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| المؤلفون: | Mainardi, Michele, Ciprietti, Dario, Pilleri, Manuela, Bonato, Giulia, Weis, Luca, Cianci, Valeria, Biundo, Roberta, Ferreri, Florinda, Piacentino, Massimo, Landi, Andrea, Guerra, Andrea, Antonini, Angelo |
| المساهمون: | Università degli Studi di Padova |
| المصدر: | Neurological Sciences ; volume 45, issue 1, page 177-185 ; ISSN 1590-1874 1590-3478 |
| بيانات النشر: | Springer Science and Business Media LLC |
| سنة النشر: | 2023 |
| الوصف: | 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. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1007/s10072-023-06999-z |
| DOI: | 10.1007/s10072-023-06999-z.pdf |
| DOI: | 10.1007/s10072-023-06999-z/fulltext.html |
| الاتاحة: | http://dx.doi.org/10.1007/s10072-023-06999-z https://link.springer.com/content/pdf/10.1007/s10072-023-06999-z.pdf https://link.springer.com/article/10.1007/s10072-023-06999-z/fulltext.html |
| Rights: | https://creativecommons.org/licenses/by/4.0 ; https://creativecommons.org/licenses/by/4.0 |
| رقم الانضمام: | edsbas.E60E87EF |
| قاعدة البيانات: | BASE |
| DOI: | 10.1007/s10072-023-06999-z |
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