Globus Pallidus Deep Brain Stimulation for Parkinson's Disease

Abstract

Deep brain stimulation (DBS) has become the treatment of choice for patients with Parkinson' disease (PD) who are experiencing unmanageable complications of long-term medical therapy. The two established sites for DBS for PD are the subthalamic nucleus (STN) and the globus pallidus interna (GPi). Although most providers have already decided that STN is the preferred site for DBS, only one small, randomized trial has compared STN to GPi DBS, finding no difference between the two procedures in improving motor function following surgery. This chapter reviews the literature on the use of unilateral and bilateral GPi on patient outcomes including motor function, quality of life, medication use, and adverse events. The available data suggests that both GPi and STN DBS are effective interventions for PD. Target choice may be dependent on patient characteristics such as age or symptom profile. Large, randomized controlled trials continue to be needed to inform these decisions.