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Title: Deep brain stimulation of pallidal versus subthalamic for patients with Parkinson's disease : a meta-analysis of controlled clinical trials
Authors: Xu, F 
Ma, W
Huang, Y 
Qiu, Z 
Sun, L 
Issue Date: 2016
Source: Neuropsychiatric disease and treatment, 2016, v. 12, p. 1435-1444
Abstract: Background: Parkinson's disease (PD) is a common neurodegenerative disorder that affects many people every year. Deep brain stimulation (DBS) is an effective nonpharmacological method to treat PD motor symptoms. This meta-analysis was conducted to evaluate the efficacy of subthalamic nucleus (STN)-DBS versus globus pallidus internus (GPi)-DBS in treating advanced PD.
Methods: Controlled clinical trials that compared STN-DBS to GPi-DBS for short-term treatment of PD in adults were researched up to November 2015. The primary outcomes were the Unified Parkinson's Disease Rating Scale Section (UPDRS) III score and the levodopa-equivalent dosage (LED) after DBS. The secondary outcomes were the UPDRS II score and the Beck Depression Inventory (BDI) score.
Results: Totally, 13 studies containing 1,148 PD patients were included in this meta-analysis to compare STN-DBS versus GPi-DBS. During the off-medication state, the pooled weighted mean difference (WMD) of UPDRS III and II scores were -2.18 (95% CI =-5.11 to 0.74) and -1.96 (95% CI =-3.84 to -0.08), respectively. During the on-medication state, the pooled WMD of UPDRS III and II scores were 0.15 (95% CI =-1.14 to 1.44) and 1.01 (95% CI = 0.12 to 1.89), respectively. After DBS, the pooled WMD of LED and BDI were -254.48 (95% CI =-341.66) and 2.29 (95% CI = 0.83 to 3.75), respectively.
Conclusion: These results indicate that during the off-medication state, the STN-DBS might be superior to GPi-DBS in improving the motor function and activities of daily living for PD patients; but during the on-medication state, the opposite result is observed. Meanwhile, the STN-DBS is superior at reducing the LED, whereas the GPi-DBS shows a significantly greater reduction in BDI score after DBS.
Keywords: Parkinson disease
Deep brain stimulation
Subthalamic nucleus
Globus pallidus internus
Publisher: Dove Medical Press
Journal: Neuropsychiatric disease and treatment 
ISSN: 1176-6328 (print)
DOI: 10.2147/NDT.S105513
Rights: © 2016 Xu et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
The following publication: Xu, F., Ma, W., Huang, Y., Qiu, Z., & Sun, L. (2016). Deep brain stimulation of pallidal versus subthalamic for patients with Parkinson's disease: a meta-analysis of controlled clinical trials. Neuropsychiatric disease and treatment, 12, 1435-44 is available at http://dx.doi.org/10.2147/NDT.S105513
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