Document Detail


Deep brain stimulation in Parkinson disease: a metaanalysis of patient outcomes.
MedLine Citation:
PMID:  16381181     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Deep brain stimulation (DBS) to treat advanced Parkinson disease (PD) has been focused on one of two anatomical targets: the subthalamic nucleus (STN) and the globus pallidus internus (GPI). Authors of more than 65 articles have reported on bilateral DBS outcomes. With one exception, these studies involved pre- and postintervention comparisons of a single target. Despite the paucity of data directly comparing STN and GPI DBS, many clinicians already consider the STN to be the preferred target site. In this study the authors conducted a metaanalysis of the existing literature on patient outcomes following DBS of the STN and the GPI. METHODS: This metaanalysis includes 31 STN and 14 GPI studies. Motor function improved significantly following stimulation (54% in patients whose STN was targeted and 40% in those whose GPI was stimulated), with effect sizes (ESs) of 2.59 and 2.04, respectively. After controlling for participant and study characteristics, patients who had undergone either STN or GPI DBS experienced comparable improved motor function following surgery (p = 0.094). The performance of activities of daily living improved significantly in patients with either target (40%). Medication requirements were significantly reduced following stimulation of the STN (ES = 1.51) but did not change when the GPI was stimulated (ES = -0.02). CONCLUSIONS: In this analysis the authors highlight the need for uniform, detailed reporting of comprehensive motor and nonmotor DBS outcomes at multiple time points and for a randomized trial of bilateral STN and GPI DBS.
Authors:
Frances Weaver; Kenneth Follett; Kwan Hur; Dolores Ippolito; Matthew Stern
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  103     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-29     Completed Date:  2006-01-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  956-67     Citation Subset:  AIM; IM    
Affiliation:
Midwest Center for Health Services and Policy Research, Edward Hines Jr. VA Hospital, IL 60141-5000, USA. Frances.Weaver@va.gov
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Antiparkinson Agents / therapeutic use
Deep Brain Stimulation*
Globus Pallidus / physiopathology
Humans
Movement
Parkinson Disease / drug therapy,  physiopathology,  therapy*
Severity of Illness Index
Subthalamic Nucleus / physiopathology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antiparkinson Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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