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European Journal of Clinical Microbiology & Infectious Diseases
Elsevier Science
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Abstract: |
Aim: This meta-analysis aims at comparing motor improvement after
subthalamic (STN) and pallidal (GPi) deep brain stimulation (DBS) for
patients with Parkinson's disease (PD).
Methods: We searched PubMed through November,2014 for prospective
controlled studies comparing STN DBS and Gpi DBS for PD patients.
Changes in UPDRS motor score, activities of daily life, verbal fluency score
and levodopa equivalent dose were pooled as standardized mean difference between two groups in a meta-analysis model using RevMan 5.3.
Results: Nine controlled trials with a total of 497 patients were eligible for
this study. The overall effect did not favor either of the two groups in terms
of improvement in UPDRS motor score (off medication SMD ¼ 0.11, 95%
CI ¼ [0.30, 0.09] and on medication SMD ¼ 0.04, 95% CI ¼ [0.15, 0.23]),
activities of daily life (SMD ¼ 0.10, 95% CI ¼ [0.31, 0.11]), semantic verbal
fluency (SMD ¼ 0.04, 95% CI ¼ [0.25, 0.16]) and phonemic verbal
fluency (SMD ¼ 0.15, 95% CI ¼ [0.35, 0.06]). The levodopa equivalent
dose was less in patients undergoing STN DBS than GPi DBS (SMD ¼ 0.29,
95% CI ¼ [0.48, 0.10]).
Conclusion: STN DBS allows more reduction in medication than GPi DBS.
Subthalmic and Pallidal DBS achieved the same motor improvement in PD
patients, so we recommend that choosing surgical target in PD patients
should be based on other non-motor outcomes.
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