• Elena Moro, Andres M Lozano, Pierre Pollak, Yves Agid, Stig Rehncrona, Jens Volkmann, Jaime Kulisevsky, Jose A Obeso, Alberto Albanese, Marwan I Hariz, Niall P Quinn, Jans D Speelman, Alim L Benabid, Valerie Fraix, Alexandre Mendes, Marie-Laure Welter, Jean-Luc Houeto, Philippe Cornu, Didier Dormont, Annalena L Tornqvist, Ron Ekberg, Alfons Schnitzler, Lars Timmermann, Lars Wojtecki, Andres Gironell, Maria C Rodriguez-Oroz, Jorge Guridi, Anna R Bentivoglio, Maria F Contarino, Luigi Romito, Massimo Scerrati, Marc Janssens, and Anthony E Lang.
• Toronto Western Hospital, Movement Disorders Center, University of Toronto and University Health Network, Toronto, Ontario, Canada. elena.moro@uhn.on.ca
• Mov. Disord. 2010 Apr 15;25(5):578-86.

AbstractWe report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-five STN patients and 16 GPi patients were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN, P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with off-stimulation, regardless of the sequence of stimulation. In open assessment, both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN, P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS in advanced PD. Although the surgical targets were not randomized, there was a trend to a better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group.(c) 2010 Movement Disorder Society.

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