Objective: To compare the therapeutic and adverse effects of the globus pallidus interna (GPi) and subthalamic nucleus (STN) deep brain stimulation (DBS) for the treatment of advanced Parkinson’s disease (PD). 

Background: DBS of both the GPi and STN has been shown to be effective in the treatment of the cardinal motor signs of PD.  However, it is still unclear whether there are definite advantages or disadvantages in selecting optimal target for DBS in PD patients.

Methods: We retrospectively analyzed the clinical data of PD patients (n = 14) underwent  GPi DBS surgery and those (n = 28) underwent STN DBS surgery between April 2002 and May 2014. Subjects were matched for age at DBS surgery and disease duration. The Unified Parkinson’s Disease Rating Scale (UPDRS) scores and levdopoa equivalent dose (LED) at baseline and 12 months after DBS surgery were used to assess therapeutic effects of DBS. The adverse effects after DBS surgery were compared between two groups. 

Results: At 12 months, the mean changes of scores for UPDRS total and each part I-IV did not differ significantly between two goups. However, subscores for gait disturbance and postural instability, and subscores for dyskinesia were significantly more improved after GPi DBS, compared with STN DBS (p = 0.024, and p = 0.016, respectively). LED was significantly more reduced in patients with STN DBS than those with GPi DBS (p = 0.004). Serious adverse effects did not differ between two groups (p = 0.697).

Conclusions: PD patients had greater improvement in gait disturbance and postural instability, and dyskinesia after GPi DBS, compared with STN DBS, although PD patients had a greater reduction in LED after STN DBS. These results may provide useful information for optimal target selection of DBS for PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparison-of-pallidal-and-subthalamic-deep-brain-stimulation-in-parkinsons-disease-therapeutic-and-adverse-effects/