Category: Surgical Therapy: Parkinson's Disease
Objective: To study the efficiency of DBS GPI in PD patients compared to DBS STN in Republican center of neurology and neurosurgery in Belarus
Background: Deep brain stimulation (DBS) efficiency in advanced Parkinson’s disease (PD) depends of chronic neuromodulation targets such as subthalamic nucleus (STN), globus pallidus pars interna (GPi) etc [1]. STN and GPI equally effective for correct motor symptoms, but insufficient evidence for specific targets for reduction dyskinesias[2]
Method: 63 patients with DBS STN, 35 m and 28 f, 55,3±8,3 y, PD duration 10,0[9,0;13,0], LEDD 1175,0[910,2;1796,1]; Ldopa duration 7,0[6,0;8,0] y, dyskinesia 1,0[0,0;2,0] y.
14 p – DBS Gpi, 3 m and 11 f, 54,8±8,7 y, PD duration 10,5[10,0;13,5] y, LEDD 912,5[750,0;1125,0]; Ldopa duration 9,5[7,0;11,0] y, dyskinesia 3,0[2,0;4,75] y. To assess the neurological status used UPDRS, to assess the changes of drug therapy used LEDD: 63 patients with DBS STN, 35 m and 28 f, 55,3±8,3 y, PD duration 10,0[9,0;13,0], LEDD 1175,0[910,2;1796,1]; Ldopa duration 7,0[6,0;8,0] y, dyskinesia 1,0[0,0;2,0] y.
14 p – DBS Gpi, 3 m and 11 f, 54,8±8,7 y, PD duration 10,5[10,0;13,5] y, LEDD 912,5[750,0;1125,0]; Ldopa duration 9,5[7,0;11,0] y, dyskinesia 3,0[2,0;4,75] y. To assess the neurological status used UPDRS, to assess the changes of drug therapy used LEDD
Results: The postoperative follow-up period was 5 years. The score by III part of UPDRS in the off-med period decreased in patients with DBS STN ANOVA χ2 = 19,15, p < ,00001 (Fig 1) and DBS Gpi ANOVA χ2 = 6,52, p = ,00013.
The off-period decreased in patients with DBS STN – ANOVA χ2 = 6,54, p < ,00001, but not change under DBS Gpi – ANOVA χ2 = 1,50, p= ,193. Reduction of dyskinesia has been observed under DBS Gpi ANOVA χ2 = 3,64, p=,004 (Fig 2), but increased under DBS STN ANOVA χ2 = 4,41, p=,0004. The score of LEDD under DBS STN was decreased ANOVA χ2 = 9,22, p < ,000001 (Fig 3), but not under DBS Gpi ANOVA χ2 = 1,46, p= ,214
Conclusion: DBS STN and DBS Gpi are equally effective to correct basic PD motor symptoms, but DBS STN allows to decrease LEDD and off period. Gpi is more effective target for reduce dyskinesia by DBS. An understanding of the target selection still depends on therapeutic goals of DBS, individual symptoms and other
References: 1. Tan ZG et al. Efficacies of globus pallidus stimulation and subthalamic nucleus stimulation for advanced Parkinson’s disease: a meta-analysis of randomized controlled trials. Clin. Interv. Aging. 2016;11:777-86. DOI: 10.2147/CIA.S105505.
2. Rughani A. et al. Congress of Neurological Surgeons systematic review and evidence-based Guideline on subthalamic nucleus and globus pallidus internus deep brain stimulation for the treatment of patients with Parkinson’s disease: Executive Summary. Neurosurgery. 2018;82(6):753-6. DOI: 10.1093/neuros/nyy037.
To cite this abstract in AMA style:
A. Buniak, V. Alexeyevets, S. Likhachev, V. Bayarchyk. Is STN a good target for decrease off period by DBS, Gpi – for reduction of dyskinesia in PD patients? [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/is-stn-a-good-target-for-decrease-off-period-by-dbs-gpi-for-reduction-of-dyskinesia-in-pd-patients/. Accessed June 14, 2025.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/is-stn-a-good-target-for-decrease-off-period-by-dbs-gpi-for-reduction-of-dyskinesia-in-pd-patients/