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Randomized trial of deep brain stimulation for Parkinson disease: Thirty-six-month outcomes
- Publication Year :
- 2012
- Publisher :
- Lippincott Williams & Wilkins, 2012.
-
Abstract
- Objectives: Our objective was to compare long-term outcomes of deep brain stimulation (DBS) of the globus pallidus interna (GPi) and subthalamic nucleus (STN) for patients with Parkinson disease (PD) in a multicenter randomized controlled trial. Methods: Patients randomly assigned to GPi (n = 89) or STN DBS (n = 70) were followed for 36 months. The primary outcome was motor function on stimulation/off medication using the Unified Parkinson9s Disease Rating Scale motor subscale. Secondary outcomes included quality of life and neurocognitive function. Results: Motor function improved between baseline and 36 months for GPi (41.1 to 27.1; 95% confidence interval [CI] −16.4 to −10.8; p p p = 0.59). Health-related quality of life improved at 6 months on all subscales (all p values significant), but improvement diminished over time. Mattis Dementia Rating Scale scores declined faster for STN than GPi patients ( p = 0.01); other neurocognitive measures showed gradual decline overall. Conclusions: The beneficial effect of DBS on motor function was stable and comparable by target over 36 months. Slight declines in quality of life following initial gains and gradual decline in neurocognitive function likely reflect underlying disease progression and highlight the importance of nonmotor symptoms in determining quality of life. Classification of Evidence: This study provides Class III evidence that improvement of motor symptoms of PD by DBS remains stable over 3 years and does not differ by surgical target. Neurology ® 2012;79:55–65
- Subjects :
- Male
medicine.medical_specialty
Neurology
Deep brain stimulation
medicine.medical_treatment
Deep Brain Stimulation
Parkinson Disease
Articles
law.invention
Subthalamic nucleus
Quality of life
Randomized controlled trial
law
Internal medicine
medicine
Physical therapy
Quality of Life
Humans
Female
Neurology (clinical)
Prospective cohort study
Psychology
Neurocognitive
Motor skill
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....bd09864131f9ff77afa34c1b44b9c273