Stable improvement seen with stimulation of the globus pallidus interna, subthalamic nucleus
THURSDAY, June 21 (HealthDay News) -- The globus pallidus interna (GPi) and subthalamic nucleus (STN) are both viable deep brain stimulation (DBS) targets for the treatment of motor symptoms in patients with Parkinson's disease, providing stable improvements over 36 months, according to a study published online June 20 in Neurology.
To compare long-term outcomes of DBS, Frances M. Weaver, Ph.D., from the Loyola University Stritch School of Medicine in Maywood, Ill., and colleagues randomly assigned patients with Parkinson's disease to receive either DBS of the GPi (89 patients) or STN (70 patients). Motor function was evaluated using the Unified Parkinson's Disease Rating Scale motor subscale.
The researchers found that motor function improved significantly over 36 months for GPi (41.1 to 27.1) and STN (42.5 to 29.7). Improvements were stable over time and did not vary between the targets. At six months, health-related quality of life improved significantly on all subscales, but the improvement decreased over time. There was a significantly faster decline in the Mattis Dementia Rating Scale scores for the STN group than the GPi group; gradual decline was seen in other neurocognitive measures.
"Our findings indicate that GPi and STN are both viable DBS targets for treatment of motor symptoms, but highlight the importance of nonmotor symptoms as determinants of quality of life in people with Parkinson's disease," the authors write.
Several authors disclosed financial ties to medical device and pharmaceutical companies, including Medtronic, which funded the study.
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