Aim:Objective
For advanced Parkinsons disease (PD), deep brain stimulation (DBS) is a well-established treatment. In the long-term, however, subthalamic nucleus (STN) DBS can result in the worsening of the axial symptoms and gait disturbance, eventually causing frequent falls. This prospective study aims to compare the effects of STN and globus pallidus interna (GPi) DBS on the motor outcome, gait and balance function, fall risk (FR), and non-motor symptoms.
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 Parkinsons 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: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.
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.