Session Information
Date: Monday, June 20, 2016
Session Title: Surgical therapy: Parkinson's disease
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To investigate the long-term outcome of pallidal deep brain stimulation (GPi-DBS) in Parkinson’s disease (PD).
Background: GPi-DBS is beneficial in patients with advanced levodopa-responsive PD. However, published long-term follow-up studies could not fully clarify the long-term sustainability of the effects.
Methods: Sixteen consecutive PD patients were treated with unilateral or bilateral stimulation of the internal part of the globus pallidus (GPi) and assessed before and six months after neurosurgery and annually thereafter for a period of up to 16 years. Primary outcomes were motor disability (Unified PD Rating Scale, UPDRS-III) and levodopa-induced motor complications (UPDRS-IV).
Results: Six months after surgery “off medication/on stimulation” UPDRS-III score was improved by 27%, after 2 years by 32%, and after 5 years by 15% when compared to baseline before surgery. However, 10 years after surgery UPDRS-III almost reached baseline score again. With the combination of pallidal stimulation and dopaminergic medication (“on medication/on stimulation”) UPDRS-III was improved by 22% after 6 months and after 2 years by 26%, but worsened in the longer follow-up in comparison to baseline. Tremor showed the best response to pallidal stimulation compared to bradykinesia and rigidity. Levodopa-induced motor complications assessed with the UPDRS-IV were improved by 49, 51, 57 and 27% at 6 months, 2, 5 and 10 years after surgery, respectively. UPDRS-IV scores remained improved throughout the whole follow-up period, but benefits began to diminish after 6 years.
Conclusions: In this monocentric study pallidal stimulation was effective in reducing Parkinsonian motor signs (UPDRS-III), mainly in the „off“ medication state, but beneficial effects vanished over a decade´s time. However, the remarkable improvement of motor complications (UPDRS-IV) was sustained for at least 10 years.
To cite this abstract in AMA style:
M.L. Lachenmayer, C. Bettschen, I. Debove, J. Muellner, C. Bernasconi, J.M. Burgunder, J.K. Krauss, M. Oertel, A. Kaelin, C. Pollo, M. Schuepbach. Stimulation of the globus pallidus internus in the treatment of Parkinson’s disease: Long-term results of a monocentric follow-up [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/stimulation-of-the-globus-pallidus-internus-in-the-treatment-of-parkinsons-disease-long-term-results-of-a-monocentric-follow-up/. Accessed June 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/stimulation-of-the-globus-pallidus-internus-in-the-treatment-of-parkinsons-disease-long-term-results-of-a-monocentric-follow-up/