Deep Brain Stimulation for Parkinson Disease: Time to Change Practice

A 3-year study shows globus pallidus interna stimulation as successful as subthalamic nucleus stimulation overall and suggests individual needs should drive the choice between the two.

Some studies have suggested that deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) has more durable benefits on motor function than DBS of the globus pallidus interna (GPi). However, long-term outcomes from randomized trials have been lacking. Now, researchers have published the long-awaited 3-year findings of the randomized, partially manufacturer-funded Veterans Affairs–National Institute of Neurological Disorders and Stroke trial comparing STN DBS with GPi DBS. Of 198 patients randomized, 159 had 36-month follow-up (89 with GPi DBS and 70 with STN DBS). The primary outcome was motor function while patients were on stimulation and off medication, measured with the Unified Parkinson's Disease Rating S…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)