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Meta-Analysis
. 2016 May 4:6:25285.
doi: 10.1038/srep25285.

Effects of neurostimulation for advanced Parkinson's disease patients on motor symptoms: A multiple-treatments meta-analysas of randomized controlled trials

Cheng-Long Xie  1 , Bei Shao  1 , Jie Chen  2 , Yi Zhou  2 , Shi-Yi Lin  2 , Wen-Wen Wang  2
Affiliations
Meta-Analysis

Effects of neurostimulation for advanced Parkinson's disease patients on motor symptoms: A multiple-treatments meta-analysas of randomized controlled trials

Cheng-Long Xie et al. Sci Rep. .

Abstract

Deep brain stimulation (DBS) is the surgical procedure of choice for patients with advanced Parkinson disease (PD). We aim to evaluate the efficacy of GPi (globus pallidus internus), STN (subthalamic nucleus)-DBS and medical therapy for PD. We conducted a systematic review and multiple-treatments meta-analysis to investigate the efficacy of neurostimulation and medical therapy for PD patients. Sixteen eligible studies were included in this analysis. We pooled the whole data and found obvious difference between GPi-DBS versus medical therapy and STN-DBS versus medical therapy in terms of UPDRS scores (Unified Parkinson's Disease Rating Scale). Meanwhile, we found GPi-DBS had the similar efficacy on the UPDRS scores when compared with STN-DBS. What is more, quality of life, measured by PDQ-39 (Parkinson's disease Questionnaire) showed greater improvement after GPi-DBS than STN-DBS. Five studies showed STN-DBS was more effective for reduction in medication than GPi-DBS. Overall, either GPi-DBS or STN-DBS was an effective technique to control PD patients' symptoms and improved their functionality and quality of life. Meanwhile, the UPDRS scores measuring parkinsonian symptoms revealed no significant difference between GPi-DBS and STN-DBS. STN-DBS was more effective for reduction in medication than GPi-DBS. Alternatively, GPi-DBS was more effective for improving the PDQ-39 score than STN-DBS.

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Figures

Figure 1
Figure 1. PRISMA 2009 Flow Diagram.
Figure 2
Figure 2. Effect sizes of GPi-DBS vs medical therapy for UPDRS Part I, UPDRS Part II (on phase), UPDRS Part II (off phase), UPDRS part III (on phase), UPDRS part III (off phase) and UPDRS Part IV (on phase).
UPDRS: Unified Parkinson’s disease Rating Scale.
Figure 3
Figure 3. Effect sizes of STN-DBS vs medical therapy for UPDRS Part I, UPDRS Part II (on phase), UPDRS Part II (off phase), UPDRS part III (on phase), UPDRS part III (off phase) and UPDRS Part IV (on phase).
Figure 4
Figure 4. Effect sizes of GPi-DBS vs STN-DBS for (A) UPDRS Part I (on phase); (B) UPDRS Part II (on phase); (C) UPDRS part III (on phase); (D) UPDRS part III (off phase) and (E) UPDRS Part IV (on phase).
Figure 5
Figure 5. Effect sizes of DBS plus medical therapy vs medical therapy for PDQ-39 (Parkinson’s disease Questionnaire).
Figure 6
Figure 6. Effect sizes of DBS plus medical therapy vs medical therapy for LED (Levodopa equivalent dose).
See this image and copyright information in PMC

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