Evidence map›Paper›PMID 34489472›Full record

ArticleNPJ Parkinson's disease2021

Subthalamic and pallidal deep brain stimulation for Parkinson's disease-meta-analysis of outcomes.

M Lenard Lachenmayer, Melina Mürset, Nicolas Antih, Ines Debove, Julia Muellner, Maëlys Bompart, Janine-Ai Schlaeppi, Andreas Nowacki, Hana You, Joan P Michelis and 4 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in NPJ Parkinson's disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 5 pooled it
9.0field-weighted citation impact, top 2% of its field
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

84 citing papers in PubMed, 5 syntheses or guidelines pooled it, 133 citations in OpenAlex.

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24 more citing papers are in PubMed but not listed here.

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

14 authors at 2 institutions in 2 countries.

M Lenard LachenmayerDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. lenard.lachenmayer@insel.ch.ORCID http://orcid.org/0000-0003-2952-6383
Melina MürsetDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Nicolas AntihAleva Neurotherapeutics SA, Lausanne, Switzerland.
Ines DeboveDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Julia MuellnerDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0002-6819-6586
Maëlys BompartAleva Neurotherapeutics SA, Lausanne, Switzerland.
Janine-Ai SchlaeppiDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Andreas NowackiDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Hana YouDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Joan P MichelisDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Alain DransartAleva Neurotherapeutics SA, Lausanne, Switzerland.
Claudio PolloDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Guenther DeuschlDepartment of Neurology, UKSH, Christian-Albrechts-University, Kiel, Germany.
Paul KrackDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
University of Bern · CHChristian-Albrechts-Universität zu Kiel · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although deep brain stimulation (DBS) of the globus pallidus internus (GPi) and the subthalamic nucleus (STN) has become an established treatment for Parkinson's disease (PD), a recent meta-analysis of outcomes is lacking. To address this gap, we performed a meta-analysis of bilateral STN- and GPi-DBS studies published from 1990-08/2019. Studies with ≥10 subjects reporting Unified Parkinson's Disease Rating Scale (UPDRS) III motor scores at baseline and 6-12 months follow-up were included. Several outcome variables were analyzed and adverse events (AE) were summarized. 39 STN studies (2035 subjects) and 5 GPi studies (292 subjects) were eligible. UPDRS-II score after surgery in the stimulation-ON/medication-OFF state compared to preoperative medication-OFF state improved by 47% with STN-DBS and 18.5% with GPi-DBS. UPDRS-III score improved by 50.5% with STN-DBS and 29.8% with GPi-DBS. STN-DBS improved dyskinesia by 64%, daily OFF time by 69.1%, and quality of life measured by PDQ-39 by 22.2%, while Levodopa Equivalent Daily Dose (LEDD) was reduced by 50.0%. For GPi-DBS information regarding dyskinesia, OFF time, PDQ-39 and LEDD was insufficient for further analysis. Correlation analysis showed that preoperative L-dopa responsiveness was highly predictive of the STN-DBS motor outcome across all studies. Most common surgery-related AE were infection (5.1%) and intracranial hemorrhage (3.1%). Despite a series of technological advances, outcomes of modern surgery are still comparable with those of the early days of DBS. Recent changes in target selection with a preference of GPi in elderly patients with cognitive deficits and more psychiatric comorbidities require more published data for validation.

Identifiers

PMID34489472
PMCPMC8421387
OpenAlexW3197794658

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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.