Related Experiment Video
Updated: Jun 12, 2026
11:12
Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
Published on: July 16, 2014
Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease
Kenneth A Follett1, Frances M Weaver, Matthew Stern
1Iowa City Veterans Affairs Medical Center, Iowa City, USA.
The New England Journal of Medicine
|June 4, 2010
Summary
Deep-brain stimulation for Parkinson's disease yielded similar motor function improvements with both globus pallidus interna and subthalamic nucleus targets. Non-motor outcomes like mood and processing speed differed, influencing target selection for deep-brain stimulation.
Area of Science:
- Neurology
- Neurosurgery
- Movement Disorders
Background:
- Deep-brain stimulation (DBS) is a key treatment for advanced Parkinson's disease.
- Globus pallidus interna (GPi) and subthalamic nucleus (STN) are established DBS targets.
- This study compares 24-month outcomes of GPi vs. STN stimulation.
Purpose of the Study:
- To compare the efficacy and safety of pallidal stimulation versus subthalamic stimulation in Parkinson's disease patients.
- To evaluate motor function, quality of life, neurocognitive effects, and adverse events.
- To inform surgical target selection for DBS in Parkinson's disease.
Main Methods:
- Randomized trial of 299 Parkinson's disease patients across 13 centers.
- Patients assigned to either pallidal stimulation (n=152) or subthalamic stimulation (n=147).
- Primary outcome: change in motor function (UPDRS-III) off medication; secondary outcomes: self-reported function, quality of life, cognition, adverse events.
Main Results:
- No significant difference in motor function improvement between GPi and STN stimulation.
- Subthalamic stimulation required lower dopaminergic medication doses.
- Subthalamic stimulation showed greater decline in visuomotor processing speed and worsened depression compared to pallidal stimulation.
Conclusions:
- Both pallidal and subthalamic stimulation provide comparable motor gains in Parkinson's disease.
- Non-motor factors, including mood and cognitive processing speed, present differences between targets.
- Consideration of non-motor outcomes is crucial for selecting the optimal DBS surgical target.
More Related Videos
Related Concept Videos
01:24Parkinson's Disease: Treatment
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
01:24Parkinson Disease ll: Pathophysiology
Parkinson disease (PD) is a progressive neurodegenerative disorder primarily affecting movement, with additional non-motor features. Its pathophysiology involves complex interactions among genetic susceptibility, environmental exposures, and cellular dysfunction, including dopaminergic neuron loss, protein aggregation, and mitochondrial impairment.Selective NeurodegenerationA key feature is the degeneration of dopaminergic neurons in the substantia nigra pars compacta, leading to reduced...
01:15Parkinson's Disease: Overview
Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is to...
01:24Parkinson Disease l: Introduction
Parkinson’s disease is a chronic, progressive neurodegenerative disorder that primarily affects movement. It is characterized by motor symptoms such as resting tremors, muscle rigidity, bradykinesia (slowness of movement), and postural instability. Patients may notice hand tremors at rest, stiffness during movement, or a shuffling gait. In addition to motor features, non-motor symptoms include sleep disturbances, mood and behavioral changes, constipation, and cognitive impairment, all of which...