LONG-TERM SUPERIORITY OF SUBTHALAMIC NUCLEUS STIMULATION OVER PALLIDOTOMY IN PARKINSON DISEASE

Abstract

The results of our multicenter randomized controlled trial comparing unilateral pallidotomy with bilateral subthalamic nucleus (STN) stimulation in advanced Parkinson disease (PD) demonstrated that STN stimulation is more effective than pallidotomy up to 1 year postoperatively.1,2 Here we present the 4-year follow-up of this trial. ### Methods. Thirty-four patients with advanced PD were randomly assigned to have unilateral pallidotomy or bilateral STN stimulation. Inclusion and exclusion criteria and study methods were described previously.1,2 The 2 assessors were blinded to the treatment allocation during the complete follow-up. For patients allocated to unilateral pallidotomy, the protocol allowed STN stimulation at least 6 months after pallidotomy. Outcome measures were the off and on phase motor Unified Parkinson's Disease Rating Scale (UPDRS) scores,3 dyskinesia severity (Clinical Dyskinesias Rating Scale),4 functional status (activities of daily living [ADL] UPDRS),3 PD Quality of Life questionnaire,5 levodopa equivalent dose,2 and adverse events. Difference in median change scores (4 years follow-up minus baseline) between treatment groups were analyzed using the Mann-Whitney U test or Kruskal-Wallis rank test, when …