1. Efficacies of globus pallidus stimulation and subthalamic nucleus stimulation for advanced Parkinson's disease: a meta-analysis of randomized controlled trials
- Author
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Tan ZG, Zhou Q, Huang T, and Jiang Y
- Subjects
advanced Parkinson’s disease ,deep brian stimulation ,globus pallidus internus ,subthalamic nucleus ,Geriatrics ,RC952-954.6 - Abstract
Zhi-Gang Tan, Qian Zhou, Tao Huang, Yugang JiangDepartment of Neurosurgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of ChinaObjectives: Deep brain stimulation (DBS) is the surgical procedure for patients with advanced Parkinson’s disease. Globus pallidus internus (GPi) and subthalamic nucleus (STN) are the most targeted locations for the procedure. To investigate the variable efficiencies for the two different locations, we conducted a meta-analysis to compare both stimulation sites.Materials and methods: A systematic search was performed in PubMed, Embase, and the Cochrane Library databases. Randomized controlled trials comparing the efficacies of GPi and STN DBS were included. Clinical outcomes of motor function, nonmotor function, and quality of life (QOL) were collected for the meta-analysis.Results: Ten eligible trials with 1,034 patients were included in the analysis. Unified Parkinson’s disease rating scale III (UPDRS-III) scores were collected at 6, 12, and 24 months postsurgery separately to assess the motor function of the patients. A statistically significant effect in favor of the GPi DBS was obtained in the off-medication/on-stimulation phase of UPDRS-III at 12 months (mean difference [MD] =6.87, 95% confidence interval [95% CI]: 3.00–10.74, P=0.57, I2=0%). However, GPi DBS showed an opposite result at 24 months (MD =−2.46, 95% CI: −4.91 to −0.02, P=0.05, I2=0%). In the on-medication/on-stimulation phase, GPi DBS obtained a worse outcome compared with STN DBS (MD =−2.90, 95% CI: −5.71 to −0.09, P=0.05, I2=0%). Compared with STN DBS, increased dosage of levodopa equivalent doses was needed in GPi DBS (standardized MD =0.60, 95% CI: 0.46–0.74, P
- Published
- 2016