STN vs. GPi deep brain stimulation for tremor suppression in Parkinson disease: A systematic review and meta-analysis.
STN vs. GPi deep brain stimulation for tremor suppression in Parkinson disease: A systematic review and meta-analysis.
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DOI：
10.1016/j.parkreldis.2018.08.017
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发表时间：
2019-01
影响因子：
4.1
通讯作者：
Okun MS
中科院分区：
文献类型：
--
作者：
Wong JK;Cauraugh JH;Ho KWD;Broderick M;Ramirez-Zamora A;Almeida L;Wagle Shukla A;Wilson CA;de Bie RM;Weaver FM;Kang N;Okun MS
比较丘脑底核（DBS）与苍白球内（GPi）DBS对帕金森病（PD）震颤抑制的效果。DBS是一种有效的外科治疗，已被证明可为PD的运动症状提供显著益处。目前，治疗PD运动并发症的两个主要结构是肌间沟和GPi。尽管一些研究小组传统上倾向于使用Glucose而不是GPi来抑制震颤，但证明长期震颤控制优越性的证据有限。我们对2017年3月之前发表的所有随机试验进行了系统性综述，这些试验比较了PD患者中的PDS-DBS与GPi DBS。在随机效应模型荟萃分析中检查了5项研究。我们进行了调节变量分析，以确定是否有一个治疗效果的差异，为西格列汀与GPi。我们比较了DBS ON与OFF，发现显著的总体标准化差异平均效应：效应量= 0.36; 95%CI = 0.316-0.395; P < 0.0001。这些发现表明DBS以中等效应量减少PD患者的震颤症状。调节变量分析显示两个显着的标准化效应量：ESTA效应量= 0.38和GPi效应量= 0.35。Z检验表明，在两种情况下，效应量无显著差异（P = 0.56）。无论刺激靶点如何，DBS均可有效减少PD患者的震颤。然而，TDBS与GPi DBS的震颤抑制程度相当。
To compare subthalamic nucleus (STN) deep brain stimulation (DBS) with globus pallidus interna (GPi) DBS for tremor suppression in Parkinson disease (PD). DBS is an effective surgical therapy that has been shown to provide significant benefit for motor symptoms in PD. Currently, two main structures targeted to treat motor complications in PD are the STN and GPi. Although some groups traditionally favor STN over GPi for tremor suppression, evidence demonstrating superiority in long-term tremor control is limited. We performed a systematic review for all randomized trials comparing STN vs GPi DBS in PD that were published before March 2017. Five studies were examined in a random effects model meta-analysis. We conducted moderator variable analysis to determine if there was a treatment effect difference for STN versus GPi. We compared DBS ON versus OFF and found a significant overall standardized difference mean effect: Effect Size = 0.36; 95% CI = 0.316–0.395; P < 0.0001. These findings indicate that DBS reduced tremor symptoms in PD patients with a medium effect size. Moderator variable analysis of STN vs GPI revealed two significant standardized effect sizes: STN effect size = 0.38 and GPi effect size = 0.35. A Z-test showed that effect sizes between the STN and GPi were not significantly different (P = 0.56). DBS is effective in reducing tremor in PD patients regardless of stimulation target. However, the degree of tremor suppression in STN DBS versus GPi DBS was equivalent.
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影响因子：
11.2
作者：
Okun, Michael S.;Fernandez, Hubert H.;Wu, Samuel S.;Kirsch-Darrow, Lindsey;Bowers, Dawn;Bova, Frank;Suelter, Michele;Jacobson, Charles E.;Wang, Xinping;Gordon, Clifford W., Jr.;Zeilman, Pam;Romrell, Janet;Martin, Pam;Ward, Herbert;Rodriguez, Ramon L.;Foote, Kelly D.
通讯作者：
Foote, Kelly D.
DOI：
10.1093/brain/awu250
发表时间：
2014-12
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Cagnan H;Little S;Foltynie T;Limousin P;Zrinzo L;Hariz M;Cheeran B;Fitzgerald J;Green AL;Aziz T;Brown P
通讯作者：
Brown P
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
9.9
作者：
Louis, ED;Levy, G;Marder, K
通讯作者：
Marder, K
影响因子：
158.5
作者：
Obeso, JA;Guridi, J;Wilkinson, S
通讯作者：
Wilkinson, S