Comparison of subthalamic nucleus vs. globus pallidus interna deep brain stimulation in terms of gait and balance; a two year follow-up study
Year: 2018
Type: article
Study design: Clinical Trial
Abstract: gets for DBS.Although the motor outcomes after STN and GPi DBS are similar, apparently, non-motor factors could affect the target selection.In addition, although both STN and GPi stimulation markedly improve postural instability and gait disorder (PIGD), contradicting studies have revealed that patients experienced more frequent falls and gait disturbance in the first 3 months postoperatively (4).Moreover, some long-term studies reported that the gait function worsened in patients with PD undergoing STN DBS (13,16,17,22,23).For instance, AIM: To compare the effects of subthalamic nucleus (STN) and globus pallidus interna (GPi) deep brain stimulation (DBS) on the motor outcome, gait and balance function, fall risk (FR), and non-motor symptoms in patients with advanced Parkinson's disease (PD). MATERIAL and METHODS:We randomized patients with advanced PD with the indication of DBS to undergo either STN or GPi DBS and followed them for 2 years.We collected data at baseline and postoperative 6, 12, and 24 months.We compared changes in the Unified Parkinson's Disease Rating Scale (UPDRS) score, timed gait tests, posturography, non-motor symptom questionnaire (NMSQuest), hospital anxiety and depression (HAD) scale, and levodopa equivalent dose (LED). RESULTS:We enrolled and randomized 12 patients to receive either STN (n = 6) or GPi (n = 6) DBS.Postoperative motor outcomes were significantly improved in both groups (p<0.05).In both groups, timed gait tests exhibited better performance in mobility; however, patients receiving GPi DBS performed better than those receiving STN DBS in the timed gait tests (p<0.05).Furthermore, the posturographic evaluation demonstrated a significant elevation in the FR in the STN group (p<0.05).CONCLUSION: Both STN and GPi DBS are equally effective in alleviating disabling motor complications.However, seemingly, STN DBS could cause more gait and balance problems; hence, a tailored approach seems to be more appropriate in the target selection.
Source: Turkish Neurosurgery
Institution: Pamukkale University
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2809944154