Table 1.
Randomized controlled trials for DBS versus BMT in PD.
| Study | Target/number | Mean age (yrs) | Baseline characteristic in the “off” state | Mean 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 |
>5 | 6 | (i) UPDRS-III: 41% improvement in DBS versus 0% in the BMT (p < 0.001). (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 (p < 0.05). (ii) PDQ-39: 24% improvement in DBS versus 0% in BMT (p < 0.05). (iii) Levodopa dose: reduced by 57% in the DBS versus 12% in the BMT (p < 0.001). |
|
| ||||||
| 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 (p < 0.001). (ii) PDQ-39: DBS group had significant improvement (p < 0.001). |
|
| ||||||
| 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 (p < 0.0001). (ii) PDQ-39: mean improvement compared with baseline was 5.0 for the DBS group versus 0.3 points in the BMT (p = 0.001). |
|
| ||||||
| 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 (p < 0.001). (ii) PDQ-39: 26% improvement in the DBS group versus no improvement in the BMT group (p = 0.002). (iii) Levodopa induced motor complications: 61% improvement in the DBS group versus no improvement in the BMT group (p < 0.001). |
|
| ||||||
| 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.