Parkinson’s Disease / 2017 / Article / Tab 1

Review Article

Earlier Intervention with Deep Brain Stimulation for Parkinson’s Disease

Table 1

Randomized controlled trials for DBS versus BMT in PD.

StudyTarget/numberMean age (yrs)Baseline characteristic in the “off” stateMean disease duration (yrs)Follow-up (mos)Outcome/conclusion

Deuschl et al. 2006 [40]STN + BMT: 78
BMT: 78
STN + BMT: 60.5
BMT: 60.8
H & Y
STN + BMT: 3.7, BMT: 3.8
UPDRS-III
SNT + BMT: 48.0, BMT: 46.8
>56(i) UPDRS-III: 41% improvement in DBS versus 0% in the BMT ().
(ii) PDQ-39: STN resulted in 14 % improvement.

Schüpbach et al. 2007 [41]Bilateral STN + BMT: 10
BMT: 10
Bilateral STN + BMT: 48.4
BMT: 48.5
H & Y
<3 
UPDRS-III
Bilateral STN + BMT: 32.7
BMT: 25.3
Bilateral STN + BMT: 7.2
BMT: 6.4
18(i) UPDRS-III: 69% improvement in DBS versus worsening in BMT ().
(ii) PDQ-39: 24% improvement in DBS versus 0% in BMT ().
(iii) Levodopa dose: reduced by 57% in the DBS versus 12% in the BMT ().

Weaver et al. 2009 [42]Bilateral STN/GPi: 121
BMT: 134
Bilateral STN/GPi: 62.4
BMT: 62.3
H & Y
Bilateral STN/GPi: 3.4,
BMT: 3.3
UPDRS-III
Bilateral STN/GPi: 43
BMT: 43.2
Bilateral STN/GPi: 10.8
BMT: 12.6
6(i) UPDRS-III: 71% of DBS patients experienced clinically meaningful motor function versus 32% of BMT patients ().
(ii) PDQ-39: DBS group had significant improvement ().

Williams et al. 2010 [43]Bilateral STN/GPi: 183
BMT: 183
DBS: 59
BMT: 59
H & Y
DBS: 3.1, BMT: 3.2 
UPDRS-III
DBS: 47.6, BMT: 48.6
DBS: 11.5
BMT: 11.2
12(i) UPDRS-III: 36% improvement in the DBS group versus 2% in BMT ().
(ii) PDQ-39: mean improvement compared with baseline was 5.0 for the DBS group versus 0.3 points in the BMT ().

Schuepbach et al. 2013 [44]SNT + BMT: 124
BMT: 127
SNT + BMT: 52.9
BMT: 52.2
H & Y
<3
UPDRS-III
STN + BMT: 33.2
BMT: 33
STN + BMT: 7.3
BMT: 7.7
24(i) UPDRS-III: 56% improvement in the DBS group versus 4% in BMT ().
(ii) PDQ-39: 26% improvement in the DBS group versus no improvement in the BMT group ().
(iii) Levodopa induced motor complications: 61% improvement in the DBS group versus no improvement in the BMT group ().

Charles et al. 2014 [39]STN + BMT: 15
BMT: 15
STN + BMT: 60
BMT: 60
H & Y
STN + BMT: 2, BMT: 2
UPDRS-III
STN + BMT: 25.3
BMT: 25.6
STN + BMT: 2.2
BMT: 2.1
24(i) UPDRS-III: mean scores were not significantly different on or off therapy.
(ii) Medication requirements in the DBS + BMT group were lower at all time points.

DBS: Deep Brain Stimulation; SNT: subthalamic nucleus; GPi: globus pallidus interna; BMT: best medical therapy.