Subthalamic Nucleus and Globus Pallidus Internus Deep Brain Stimulation for the Treatment of Patients with Parkinson's Disease
Publication Date: March 1, 2018
Last Updated: March 14, 2022
RECOMMENDATIONS
Given that bilateral STN DBS is at least as effective as bilateral GPi DBS in treating motor symptoms of Parkinson’s disease (as measured by improvements in UPDRS-III scores), consideration can be given to the selection of either target in patients undergoing surgery to treat motor symptoms. (A)
334012
When the main goal of surgery is reduction of dopaminergic medications in a patient with Parkinson’s disease, then bilateral STN DBS should be performed instead of GPi DBS. (A)
334012
There is insufficient evidence to make a generalizable recommendation regarding the target selection for reduction of dyskinesias. However, when the reduction of medication is not anticipated and there is a goal to reduce the severity of “on”medication dyskinesias, the GPi should be targeted. (A)
334012
When considering improvements in quality of life in a patient undergoing DBS for Parkinson’s disease, there is no basis to recommend bilateral DBS in 1 target over the other. (A)
334012
If there is significant concern about cognitive decline, particularly in regards to processing speed and working memory in a patient undergoing DBS, then the clinician should consider using GPi DBS rather than STN DBS, while taking into consideration other goals of surgery. (A)
334012
If there is significant concern about the risk of depression in a patient undergoing DBS, then the clinician should consider using pallidal rather than STN stimulation, while taking into consideration other goals of surgery. (A)
334012
There is insufficient evidence to recommend bilateral DBS in 1 target over the other in order to minimize the risk of surgical adverse events. ()
334012
Recommendation Grading
Overview
Title
Subthalamic Nucleus and Globus Pallidus Internus Deep Brain Stimulation for the Treatment of Patients with Parkinson's Disease
Authoring Organization
Congress of Neurological Surgeons
Publication Month/Year
March 1, 2018
Last Updated Month/Year
August 7, 2023
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adolescent, Adult
Health Care Settings
Ambulatory, Outpatient
Intended Users
Physician, nurse, nurse practitioner, physician assistant
Scope
Management, Treatment
Diseases/Conditions (MeSH)
D010300 - Parkinson Disease, D046690 - Deep Brain Stimulation, D020531 - Subthalamic Nucleus, D005917 - Globus Pallidus
Keywords
Parkinson's disease, Subthalamic nucleus, Neuromodulation, Globus pallidus internus, deep brain stimulation