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October 2005

Pallidal vs Subthalamic Deep Brain Stimulation for Parkinson Disease: Winner and Loser or a Sharing of Honors?

Arch Neurol. 2005;62(10):1642-1643. doi:10.1001/archneur.62.10.1642-b

The delightfully illustrated and timely editorial1 on the “rematch” between globus pallidus interna (GPi) and subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson disease was of special interest to our group, which just published a further contribution on this issue based on a nonrandomized study.2 The confirmation by Anderson and colleagues,3 in the only randomized, blinded comparative study to date, that STN and GPi DBS are equally effective in relieving motor symptoms and levodopa-induced dyskinesia at 1 year challenges the widely held assumption that STN is a superior target. They observed greater improvements in bradykinesia and higher levodopa dose reduction in their STN group but without significance (P>.05). These results require confirmation in wider studies over a longer term.

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