Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

July 03, 2012; 79 (1) Articles

Randomized trial of deep brain stimulation for Parkinson disease

Thirty-six-month outcomes

Frances M. Weaver, Kenneth A. Follett, Matthew Stern, Ping Luo, Crystal L. Harris, Kwan Hur, William J. Marks, Johannes Rothlind, Oren Sagher, Claudia Moy, Rajesh Pahwa, Kim Burchiel, Penelope Hogarth, Eugene C. Lai, John E. Duda, Kathryn Holloway, Ali Samii, Stacy Horn, Jeff M. Bronstein, Gatana Stoner, Philip A. Starr, Richard Simpson, Gordon Baltuch, Antonio De Salles, Grant D. Huang, Domenic J. Reda
First published June 20, 2012, DOI: https://doi.org/10.1212/WNL.0b013e31825dcdc1
Frances M. Weaver
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kenneth A. Follett
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Matthew Stern
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ping Luo
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Crystal L. Harris
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kwan Hur
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
William J. Marks Jr.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Johannes Rothlind
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Oren Sagher
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Claudia Moy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rajesh Pahwa
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kim Burchiel
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Penelope Hogarth
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Eugene C. Lai
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John E. Duda
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kathryn Holloway
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ali Samii
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Stacy Horn
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jeff M. Bronstein
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gatana Stoner
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Philip A. Starr
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard Simpson
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gordon Baltuch
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Antonio De Salles
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Grant D. Huang
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Domenic J. Reda
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Randomized trial of deep brain stimulation for Parkinson disease
Thirty-six-month outcomes
Frances M. Weaver, Kenneth A. Follett, Matthew Stern, Ping Luo, Crystal L. Harris, Kwan Hur, William J. Marks, Johannes Rothlind, Oren Sagher, Claudia Moy, Rajesh Pahwa, Kim Burchiel, Penelope Hogarth, Eugene C. Lai, John E. Duda, Kathryn Holloway, Ali Samii, Stacy Horn, Jeff M. Bronstein, Gatana Stoner, Philip A. Starr, Richard Simpson, Gordon Baltuch, Antonio De Salles, Grant D. Huang, Domenic J. Reda
Neurology Jul 2012, 79 (1) 55-65; DOI: 10.1212/WNL.0b013e31825dcdc1

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
2445

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objectives: Our objective was to compare long-term outcomes of deep brain stimulation (DBS) of the globus pallidus interna (GPi) and subthalamic nucleus (STN) for patients with Parkinson disease (PD) in a multicenter randomized controlled trial.

Methods: Patients randomly assigned to GPi (n = 89) or STN DBS (n = 70) were followed for 36 months. The primary outcome was motor function on stimulation/off medication using the Unified Parkinson's Disease Rating Scale motor subscale. Secondary outcomes included quality of life and neurocognitive function.

Results: Motor function improved between baseline and 36 months for GPi (41.1 to 27.1; 95% confidence interval [CI] −16.4 to −10.8; p < 0.001) and STN (42.5 to 29.7; 95% CI −15.8 to −9.4; p < 0.001); improvements were similar between targets and stable over time (p = 0.59). Health-related quality of life improved at 6 months on all subscales (all p values significant), but improvement diminished over time. Mattis Dementia Rating Scale scores declined faster for STN than GPi patients (p = 0.01); other neurocognitive measures showed gradual decline overall.

Conclusions: The beneficial effect of DBS on motor function was stable and comparable by target over 36 months. Slight declines in quality of life following initial gains and gradual decline in neurocognitive function likely reflect underlying disease progression and highlight the importance of nonmotor symptoms in determining quality of life.

Classification of Evidence: This study provides Class III evidence that improvement of motor symptoms of PD by DBS remains stable over 3 years and does not differ by surgical target. Neurology® 2012;79:55–65

GLOSSARY

BDI-II=
Beck Depression Inventory II;
CI=
confidence interval;
DBS=
deep brain stimulation;
GPi=
globus pallidus interna;
PD=
Parkinson disease;
PDQ-39=
PD Questionnaire-39;
RCT=
randomized controlled trial;
STN=
subthalamic nucleus;
UPDRS III=
Unified Parkinson's Disease Rating Scale motor subscale;
VA=
Veterans Affairs

Footnotes

  • Study funding: Medtronic Neurological, Inc. provided financial support. The Cooperative Studies Program, Department of Veterans Affairs Office of Research and Development, provided financial support and contributed to the study design. NINDS provided financial support and contributed to the design of the study.

  • Editorial, page 19

  • Supplemental data at www.neurology.org.

  • Coinvestigators and Contributors are listed on the Neurology® Web site at www.neurology.org.

  • The full protocol is available from the Department of Veterans Affairs, Cooperative Studies Program Office within the Office of Research & Development, Washington, DC, CSP@va.gov or 202-461-1700.

  • The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the National Institute of Neurological Disorders and Stroke.

  • Received June 9, 2011.
  • Accepted November 17, 2011.
  • Copyright © 2012 by AAN Enterprises, Inc.
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Letters: Rapid online correspondence

  • Randomized trial of deep brain stimulation for Parkinson disease: Thirty-six-month outcomes
    • Erwin Montgomery, Professor, University at Birmingham, emontgom@uab.edu
    Submitted July 19, 2012
  • Reply to Montgomery
    • Matthew Stern, mbstern@mail.med.upenn.edu
    • Kenneth A. Follett, MD, PhD; Omaha, NE; Frances M Weaver, PhD; Chicago, Il.
    Submitted July 19, 2012
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • GLOSSARY
    • METHODS
    • RESULTS
    • DISCUSSION
    • AUTHOR CONTRIBUTIONS
    • DISCLOSURE
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
Advertisement

Hemiplegic Migraine Associated With PRRT2 Variations A Clinical and Genetic Study

Dr. Robert Shapiro and Dr. Amynah Pradhan

► Watch

Related Articles

  • Turning tablesShould GPi become the preferred DBS target for Parkinson disease?

Topics Discussed

  • All Movement Disorders
  • Class III
  • Prognosis
  • Parkinson's disease/Parkinsonism
  • Surgery/Stimulation

Alert Me

  • Alert me when eletters are published
Neurology: 100 (5)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise