Objective: To compare short-term motor and non-motor outcomes following directional versus omnidirectional stimulation in Parkinson’s disease (PD) cases undergoing bilateral globus pallidus internus (GPi) DBS at 3 and 6 months after surgery. We also compared quality of life scores, therapeutic windows, and total electrical energy delivered (TEED) in both groups.

Background: Directional deep brain stimulation (DBS) allows radial steering of ecurrent toward therapeutic “sweet spots” while minimizing current spread. This could potentially provide better motor and non-motor outcomes at lower electrical energy levels

Method: In this prospective, non-randomized, cohort study PD cases who underwent GPi-DBS using either omnidirectional stimulation or directional stimulation in the preceding 2-years were recruited. Unified Parkinson’s Disease Rating Scale (UPDRS) parts III and IV, Non-Motor Symptoms Scale (NMSS), Parkinson’s Disease Questionnaire-39 (PDQ-39), Frontal Assessment Battery (FAB), Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), and Parkinson’s Disease Sleep Scale (PDSS) were performed preoperatively and 3 and 6 months after DBS.

Results: Seventy-three patients (43 men) participated. 61 patients received omnidirectional  and 12 patients directional stimulation. The mean age was 63± 6.87 years and the mean disease duration was 10 ± 4.87years. After adjusting  baseline characteristics and scores, no significant differences were seen between the groups in UPDRS part III at 3 months (p = 0.678) or 6 months (p=0.37),UPDRS part IV-A and IV-B at 3 months (p = 0.674) or 6 months (p = 0.373), non-motor outcomes of NMSS, MoCA, FAB, BDI, PDSS, and PDQ-39 scores at 3 and 6 months (all comparisons P>0.05).  Therapeutic window was  wider in the directional stimulation group at 6 months for both GPi (p = 0.003 and p = 0.002). TEED was lower in the directional stimulation group (right GPi: p = 0.02; left GPi: p = 0.01) at 6 months.

Conclusion: Directional and omnidirectional GPi-DBS provide comparable improvements in motor and non-motor symptoms and quality of life in patients with PD. However, directional stimulation  gives a wider therapeutic window and requires lower electrical energy thus providing greater flexibility for future stimulation adjustment along with potential battery longevity

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/directional-versus-omnidirectional-gpi-dbs-in-parkinsons-disease/