Deep Brain Stimulation for Medically Refractory Parkinson's Disease: A Systematic Review

Abstract

Introduction: Deep brain stimulation (DBS) is a neurosurgical procedure used to treat the motor symptoms of Parkinson's disease (PD) that are no longer adequately controlled by medication. This review evaluates the efficacy and safety of DBS in this patient population.

Methods: A systematic search for RCTs was conducted. We included studies comparing DBS (of the subthalamic nucleus or globus pallidus interna) plus optimal medical therapy to optimal medical therapy alone in patients with advanced PD. The primary outcome was improvement in motor function.

Results: The meta-analysis of eight RCTs demonstrated that DBS resulted in a clinically and statistically significant improvement in motor function, activities of daily living, and overall quality of life compared to medical therapy alone. This benefit came at the cost of a higher risk of procedure-related adverse events.

Discussion: DBS is a highly effective therapy for improving motor control and quality of life in selected patients with advanced Parkinson's disease. Careful patient selection and multidisciplinary team management are essential to optimize benefits and minimize risks.

Conclusion: Deep brain stimulation is superior to optimal medical therapy for improving motor function and quality of life in advanced Parkinson's disease.