Deep Brain Stimulation of the Globus Pallidus Internus and Externus in Multiple System Atrophy

Background Multiple system atrophy with parkinsonism (MSA‐P) is a progressive condition with no effective treatment. Objective The aim of this study was to describe the safety and efficacy of deep brain stimulation (DBS) of globus pallidus pars interna and externa in a cohort of patients with MSA‐P....

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Published in:Movement disorders 2023-11, Vol.38 (11), p.2121-2125
Main Authors: Di Luca, Daniel G., Ramirez‐Gomez, Carolina, Germann, Jurgen, Santyr, Brendan, Boutet, Alexandre, Milosevic, Luka, Lang, Anthony E., Kalia, Suneil K., Lozano, Andres M., Fasano, Alfonso
Format: Article
Language:English
Subjects:
Atrophy
Basal ganglia
Central nervous system diseases
Deep brain stimulation
Dyskinesia
Globus pallidus
Levodopa
Localization
Movement disorders
multiple system atrophy
Neurodegenerative diseases
neuromodulation
Parkinson's disease
Patients
Surgery
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Summary:Background Multiple system atrophy with parkinsonism (MSA‐P) is a progressive condition with no effective treatment. Objective The aim of this study was to describe the safety and efficacy of deep brain stimulation (DBS) of globus pallidus pars interna and externa in a cohort of patients with MSA‐P. Methods Six patients were included. Changes in Movement Disorders Society Unified Parkinson's Disease Rating Scale Part III (MDS‐UPDRS III), Parkinson's Disease Questionnaire (PDQ‐39) scores, and levodopa equivalent daily dose were compared before and after DBS. Electrode localization and volume tissue activation were calculated. Results DBS surgery did not result in any major adverse events or intraoperative complications. Overall, no differences in MDS‐UPDRS III scores were demonstrated (55.2 ± 17.6 preoperatively compared with 67.3 ± 19.2 at 1 year after surgery), although transient improvement in mobility and dyskinesia was reported in some subjects. Conclusions Globus pallidus pars interna and externa DBS for patients with MSA‐P did not result in major complications, although it did not provide significant clinical benefit as measured by MDS‐UPDRS III. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.29573