Abstract
Deep brain stimulation (DBS) is a surgical treatment in which stimulation electrodes are permanently implanted in basal ganglia to treat motor fluctuations and symptoms of Parkinson’s disease (PD). Subthalamic nucleus (STN) and globus pallidus internus (GPi) are the commonly used targets for DBS in PD. Many studies have compared motor and non-motor outcomes of DBS in both targets. However, the selection of PD patients for DBS targets is still poorly studied. Therefore, we performed this narrative review to summarize published studies comparing STN DBS and GPi DBS. GPi DBS is better for patients with problems in speech, mood, or cognition while STN DBS is better from an economic point of view as it allows much reduction in antiparkinson medications and less battery consumption.
Highlights
BackgroundParkinson's disease (PD) is a motor disorder characterized by progressive degeneration of dopaminergic neurons in the basal ganglia (BG)
There was no significant difference between Subthalamic nucleus (STN) Deep brain stimulation (DBS) and globus pallidus internus (GPi) DBS in UPDRS III motor score
Current evidence suggests that there is no significant difference between STN DBS and GPi DBS in terms of motor improvement on the UPDRS III score STN DBS allows more reduction in antiparkinsonian medication
Summary
Parkinson's disease (PD) is a motor disorder characterized by progressive degeneration of dopaminergic neurons in the basal ganglia (BG). This degeneration causes overactivity of subthalamic nucleus (STN) leading to increased globus pallidus internus (GPi) output, which causes PD symptoms. Pharmacological treatments enhance the dopaminergic action in the BG They reduce PD symptoms that are mainly due to lack of dopamine. There is a need to summarize the available evidence to help neurologists select patients for DBS targets. We performed this narrative review to summarize published meta-analyses and randomized controlled trials (RCTs) comparing STN DBS and GPi DBS.
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