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Thursday, October 20, 2016

Parkinson’s disease: GPi DBS improves motor symptoms but impairs speech

October 20, 2016

Takeaway
  • Patients with advanced Parkinson’s disease (PD) and contraindications to subthalamic surgery saw improvement in motor symptoms, especially dyskinesias, but with a decline in speech, in response to bilateral deep brain stimulation (DBS) to the globus pallidus pars interna (GPi).
Why this matters
  • The optimal DBS target is still debated, with some studies showing the subthalamic nucleus (STN) a better target than the GPi.
  • STN DBS can carry side-effects, including cognitive decline and worsening dopa-resistant axial motor symptoms.
Key results
  • In patients stimulated in off-medication condition, motor score improvement on the United Parkinson’s Disease Rating Scale (UPDRS)-III was 19.8% at month 12 (P=.04), and remained stable at year 3, with an improvement above baseline of 20.6% (P=.04).
  • The speech subscore worsened significantly at year ...
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