Comparison of Pallidal and Subthalamic Deep Brain Stimulation in Parkinson’s Disease: Therapeutic and Adverse Effects
Objective To compare the therapeutic and adverse effects of globus pallidus interna (GPi) and subthalamic nucleus (STN) deep brain stimulation (DBS) for the treatment of advanced Parkinson’s disease (PD). Methods We retrospectively analyzed the clinical data of patients with PD who underwent GPi (n...
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| Format: | Article |
| Language: | English |
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Korean Movement Disorder Society
2017-05-01
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| Series: | Journal of Movement Disorders |
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| Online Access: | http://www.e-jmd.org/upload/jmd-17001.pdf |
| _version_ | 1797760926965825536 |
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| author | Ho-Sung Ryu Mi-Sun Kim Sooyeoun You Mi-Jung Kim Young Jin Kim Juyeon Kim Kiju Kim Sun Ju Chung |
| author_facet | Ho-Sung Ryu Mi-Sun Kim Sooyeoun You Mi-Jung Kim Young Jin Kim Juyeon Kim Kiju Kim Sun Ju Chung |
| author_sort | Ho-Sung Ryu |
| collection | DOAJ |
| description | Objective To compare the therapeutic and adverse effects of globus pallidus interna (GPi) and subthalamic nucleus (STN) deep brain stimulation (DBS) for the treatment of advanced Parkinson’s disease (PD). Methods We retrospectively analyzed the clinical data of patients with PD who underwent GPi (n = 14) or STN (n = 28) DBS surgery between April 2002 and May 2014. The subjects were matched for age at surgery and disease duration. The Unified Parkinson’s Disease Rating Scale (UPDRS) scores and levodopa equivalent dose (LED) at baseline and 12 months after surgery were used to assess the therapeutic effects of DBS. Adverse effects were also compared between the two groups. Results At 12 months, the mean changes in the UPDRS total and part I–IV scores did not differ significantly between the two groups. However, the subscores for gait disturbance/postural instability and dyskinesia were significantly more improved after GPi DBS than those after STN DBS (p = 0.024 and 0.016, respectively). The LED was significantly more reduced in patients after STN DBS than that after GPi DBS (p = 0.004). Serious adverse effects did not differ between the two groups (p = 0.697). Conclusion The patients with PD showed greater improvement in gait disturbance/postural instability and dyskinesia after GPi DBS compared with those after STN DBS, although the patients had a greater reduction in LED after STN DBS. These results may provide useful information for optimal target selection for DBS in PD. |
| first_indexed | 2024-03-12T19:05:35Z |
| format | Article |
| id | doaj.art-c34c5a7c80cb436f9a5825751730f8ea |
| institution | Directory Open Access Journal |
| issn | 2005-940X 2093-4939 |
| language | English |
| last_indexed | 2024-03-12T19:05:35Z |
| publishDate | 2017-05-01 |
| publisher | Korean Movement Disorder Society |
| record_format | Article |
| series | Journal of Movement Disorders |
| spelling | doaj.art-c34c5a7c80cb436f9a5825751730f8ea2023-08-02T06:17:01ZengKorean Movement Disorder SocietyJournal of Movement Disorders2005-940X2093-49392017-05-01102808610.14802/jmd.17001191Comparison of Pallidal and Subthalamic Deep Brain Stimulation in Parkinson’s Disease: Therapeutic and Adverse EffectsHo-Sung Ryu0Mi-Sun Kim1Sooyeoun You2Mi-Jung Kim3Young Jin Kim4Juyeon Kim5Kiju Kim6Sun Ju Chung7 Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Neurology, Dongsan Medical Center, Keimyung University, Daegu, Korea Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Neurology, Best Heals Hospital, Ansan, Korea Department of Neurology, Metro Hospital, Anyang, Korea Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaObjective To compare the therapeutic and adverse effects of globus pallidus interna (GPi) and subthalamic nucleus (STN) deep brain stimulation (DBS) for the treatment of advanced Parkinson’s disease (PD). Methods We retrospectively analyzed the clinical data of patients with PD who underwent GPi (n = 14) or STN (n = 28) DBS surgery between April 2002 and May 2014. The subjects were matched for age at surgery and disease duration. The Unified Parkinson’s Disease Rating Scale (UPDRS) scores and levodopa equivalent dose (LED) at baseline and 12 months after surgery were used to assess the therapeutic effects of DBS. Adverse effects were also compared between the two groups. Results At 12 months, the mean changes in the UPDRS total and part I–IV scores did not differ significantly between the two groups. However, the subscores for gait disturbance/postural instability and dyskinesia were significantly more improved after GPi DBS than those after STN DBS (p = 0.024 and 0.016, respectively). The LED was significantly more reduced in patients after STN DBS than that after GPi DBS (p = 0.004). Serious adverse effects did not differ between the two groups (p = 0.697). Conclusion The patients with PD showed greater improvement in gait disturbance/postural instability and dyskinesia after GPi DBS compared with those after STN DBS, although the patients had a greater reduction in LED after STN DBS. These results may provide useful information for optimal target selection for DBS in PD.http://www.e-jmd.org/upload/jmd-17001.pdfParkinson’s diseasedeep brain stimulationglobus pallidus internasubthalamic nucleus. |
| spellingShingle | Ho-Sung Ryu Mi-Sun Kim Sooyeoun You Mi-Jung Kim Young Jin Kim Juyeon Kim Kiju Kim Sun Ju Chung Comparison of Pallidal and Subthalamic Deep Brain Stimulation in Parkinson’s Disease: Therapeutic and Adverse Effects Journal of Movement Disorders Parkinson’s disease deep brain stimulation globus pallidus interna subthalamic nucleus. |
| title | Comparison of Pallidal and Subthalamic Deep Brain Stimulation in Parkinson’s Disease: Therapeutic and Adverse Effects |
| title_full | Comparison of Pallidal and Subthalamic Deep Brain Stimulation in Parkinson’s Disease: Therapeutic and Adverse Effects |
| title_fullStr | Comparison of Pallidal and Subthalamic Deep Brain Stimulation in Parkinson’s Disease: Therapeutic and Adverse Effects |
| title_full_unstemmed | Comparison of Pallidal and Subthalamic Deep Brain Stimulation in Parkinson’s Disease: Therapeutic and Adverse Effects |
| title_short | Comparison of Pallidal and Subthalamic Deep Brain Stimulation in Parkinson’s Disease: Therapeutic and Adverse Effects |
| title_sort | comparison of pallidal and subthalamic deep brain stimulation in parkinson s disease therapeutic and adverse effects |
| topic | Parkinson’s disease deep brain stimulation globus pallidus interna subthalamic nucleus. |
| url | http://www.e-jmd.org/upload/jmd-17001.pdf |
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