Evidence map›Paper›PMID 31813194›Full record

ArticleAnnals of clinical and translational neurology2020

Pallidal versus subthalamic nucleus deep brain stimulation for levodopa-induced dyskinesia.

Shi-Ying Fan, Kai-Liang Wang, Wei Hu, Robert S Eisinger, Alexander Han, Chun-Lei Han, Qiao Wang, Shimabukuro Michitomo, Jian-Guo Zhang, Feng Wang and 2 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of clinical and translational neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. What's in a name? reframing advanced Parkinson's disease as a multidimensional state.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
  3. Article
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  12. Deep brain stimulation of globus pallidus internus and subthalamic nucleus in Parkinson's disease: a multicenter, retrospective study of efficacy and safety.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Shi-Ying FanDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Kai-Liang WangDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Wei HuDepartment of Neurology, Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, 32607.
Robert S EisingerDepartment of Neurology, Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, 32607.
Alexander HanDepartment of Neurology, Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, 32607.
Chun-Lei HanDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Qiao WangDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Shimabukuro MichitomoDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Jian-Guo ZhangDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Feng WangDepartments of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
Adolfo Ramirez-ZamoraDepartment of Neurology, Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, 32607.ORCID 0000-0001-9253-3899
Fan-Gang MengDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.ORCID 0000-0002-8577-6443

Funding

Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support ZYLX201820National Natural Science Foundation of China 81971070The Key Research Project of Ningxia 2018BFG02007
6 · The paper itself

Abstract

objectiveTo compare the efficacy of subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) on reducing levodopa-induced dyskinesia (LID) in Parkinson's disease, and to explore the potential underlying mechanisms.

methodsWe retrospectively assessed clinical outcomes in 43 patients with preoperative LID who underwent DBS targeting the STN (20/43) or GPi (23/43). The primary clinical outcome was the change from baseline in the Unified Dyskinesia Rating Scale (UDysRS) and secondary outcomes included changes in the total daily levodopa equivalent dose, the drug-off Unified Parkinson Disease Rating Scale Part Ⅲ at the last follow-up (median, 18 months), adverse effects, and programming settings. Correlation analysis was used to find potential associated factors that could be used to predict the efficacy of DBS for dyskinesia management.

resultsCompared to baseline, both the STN group and the GPi group showed significant improvement in LID with 60.73 ± 40.29% (mean ± standard deviation) and 93.78 ± 14.15% improvement, respectively, according to the UDysRS score. Furthermore, GPi-DBS provided greater clinical benefit in the improvement of dyskinesia (P < 0.05) compared to the STN. Compared to the GPi group, the levodopa equivalent dose reduction was greater in the STN group at the last follow-up (43.81% vs. 13.29%, P < 0.05). For the correlation analysis, the improvement in the UDysRS outcomes were significantly associated with a reduction in levodopa equivalent dose in the STN group (r = 0.543, P = 0.013), but not in the GPi group (r = -0.056, P = 0.801).

interpretationBoth STN and GPi-DBS have a beneficial effect on LID but GPi-DBS provided greater anti-dyskinetic effects. Dyskinesia suppression for STN-DBS may depend on the reduction of levodopa equivalent dose. Unlike the STN, GPi-DBS might exert a direct and independent anti-dyskinesia effect.

Indexed as

Deep Brain StimulationGlobus PallidusOutcome Assessment, Health CareSubthalamic NucleusAgedAntiparkinson AgentsDyskinesia, Drug-InducedFemaleFollow-Up StudiesHumansLevodopaMaleMiddle AgedParkinson DiseaseRetrospective StudiesAntiparkinson AgentsLevodopa

Identifiers

PMID31813194
PMCPMC6952311

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.