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The long-term efficacy of STN vs GPi deep brain stimulation for Parkinson disease: A meta-analysis.
Medicine (Baltimore). 2018 Aug; 97(35):e12153.M

Abstract

OBJECTIVE

This meta-analysis assessed the long-term efficacy of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus interna (GPi) for Parkinson disease (PD).

METHODS

PubMed, Cochrane Library, and Clinical Trials databases were searched. Outcomes were unified Parkinson disease rating scale section (UPDRS) III off-medication score, Parkinson's disease questionnaire: 39 activities of daily living (PDQ-39 ADL) score, and levodopa-equivalent dosage after DBS.

RESULTS

During the off-medication state, pooled weighted mean difference (WMD) of UPDRS III score was .69 (95% confidence interval [CI] = -1.77 to 3.16, P = .58). In subgroup analysis, WMD of UPDRS III off-medication scores from baseline to 2 years and 3 years post-DBS were -.61 (95% CI = -2.97 to 1.75, P = .61) and 2.59 (95% CI = -2.30 to 7.47, P = .30). Pooled WMD of changes in tremor, rigidity, and gait scores were 1.12 (95% CI = -0.05 to 2.28, P = .06), 1.22 (95% CI = -0.51 to 2.94, P = .17) and .37 (95% CI = -0.13 to 0.87, P = .15), respectively. After DBS, pooled WMD of PDQ-39 ADL and LED were -3.36 (95% CI = -6.36 to -0.36, P = .03) and 194.89 (95% CI = 113.16 to 276.63, P < .001).

CONCLUSIONS

STN-DBS and GPi-DBS improve motor function and activities of daily living for PD. Differences in the long-term efficacy for PD on motor symptoms were not observed.

Authors+Show Affiliations

Department of Neurosurgery Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

30170458

Citation

Peng, Lilei, et al. "The Long-term Efficacy of STN Vs GPi Deep Brain Stimulation for Parkinson Disease: a Meta-analysis." Medicine, vol. 97, no. 35, 2018, pp. e12153.
Peng L, Fu J, Ming Y, et al. The long-term efficacy of STN vs GPi deep brain stimulation for Parkinson disease: A meta-analysis. Medicine (Baltimore). 2018;97(35):e12153.
Peng, L., Fu, J., Ming, Y., Zeng, S., He, H., & Chen, L. (2018). The long-term efficacy of STN vs GPi deep brain stimulation for Parkinson disease: A meta-analysis. Medicine, 97(35), e12153. https://doi.org/10.1097/MD.0000000000012153
Peng L, et al. The Long-term Efficacy of STN Vs GPi Deep Brain Stimulation for Parkinson Disease: a Meta-analysis. Medicine (Baltimore). 2018;97(35):e12153. PubMed PMID: 30170458.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The long-term efficacy of STN vs GPi deep brain stimulation for Parkinson disease: A meta-analysis. AU - Peng,Lilei, AU - Fu,Jie, AU - Ming,Yang, AU - Zeng,Shan, AU - He,Haiping, AU - Chen,Ligang, PY - 2018/9/2/entrez PY - 2018/9/2/pubmed PY - 2018/9/7/medline SP - e12153 EP - e12153 JF - Medicine JO - Medicine (Baltimore) VL - 97 IS - 35 N2 - OBJECTIVE: This meta-analysis assessed the long-term efficacy of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus interna (GPi) for Parkinson disease (PD). METHODS: PubMed, Cochrane Library, and Clinical Trials databases were searched. Outcomes were unified Parkinson disease rating scale section (UPDRS) III off-medication score, Parkinson's disease questionnaire: 39 activities of daily living (PDQ-39 ADL) score, and levodopa-equivalent dosage after DBS. RESULTS: During the off-medication state, pooled weighted mean difference (WMD) of UPDRS III score was .69 (95% confidence interval [CI] = -1.77 to 3.16, P = .58). In subgroup analysis, WMD of UPDRS III off-medication scores from baseline to 2 years and 3 years post-DBS were -.61 (95% CI = -2.97 to 1.75, P = .61) and 2.59 (95% CI = -2.30 to 7.47, P = .30). Pooled WMD of changes in tremor, rigidity, and gait scores were 1.12 (95% CI = -0.05 to 2.28, P = .06), 1.22 (95% CI = -0.51 to 2.94, P = .17) and .37 (95% CI = -0.13 to 0.87, P = .15), respectively. After DBS, pooled WMD of PDQ-39 ADL and LED were -3.36 (95% CI = -6.36 to -0.36, P = .03) and 194.89 (95% CI = 113.16 to 276.63, P < .001). CONCLUSIONS: STN-DBS and GPi-DBS improve motor function and activities of daily living for PD. Differences in the long-term efficacy for PD on motor symptoms were not observed. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/30170458/The_long_term_efficacy_of_STN_vs_GPi_deep_brain_stimulation_for_Parkinson_disease:_A_meta_analysis_ L2 - https://doi.org/10.1097/MD.0000000000012153 DB - PRIME DP - Unbound Medicine ER -