Clinical Effectiveness of DBS for Parkinson's Disease

There are several globally recognized tools used to monitor the severity of Parkinson’s disease as well as track the quality of life. The Unified Parkinson's Disease Rating Scale (UPDRS) is a globally recognized tool used to assess the severity of Parkinson’s disease. The Parkinson’s disease Questionnaire (PDQ-39) is used to measure the health status of people living with Parkinson’s disease specifically focusing on 8 aspects related to quality of life.

Multiple studies have demonstrated a reduction in UPDRS III and PDQ-39 scores, which correlates with an improvement in motor function & quality of life.

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Key findings from these studies concluded that:

Primary
Author

 Study
Design		 Sample
Size		 Follow
Up		 Change in Mean
UPDRS III Scores

% Improvement in UPDRS III &

PDQ-39 Scores
Deuschl 2006¹

Randomized

pairs trial

 78 6 mos.

• Baseline: 48 ± 12.3

• Post DBS: 28.3 ± 14

• 41% improvement in UPDRS III

• 25% improvement in PDQ-39
Tir 2007²

Prospective,

single-center

study

 103 12 mos.

• Baseline: 50 ± 16

• Post DBS: 29 ± 11.5

 • 42% improvement in UPDRS III
Fraix 2006³

Prospective,

multi-center

 95 12 mos.

Baseline: 49.2 ± 16.4

• Post DBS: 19.4 ± 11.5

 • 57% improvement in UPDRS III

Lefaucheur

2008⁴

Single-center

study

 54 12 mos.

Baseline: 48.2 ± 16.1

• Post DBS: 21.4 ± 8.2

 • 56% improvement in UPDRS III
Follett 2010⁵

Multi-center,

randomized,

blinded

 299 24 mos.

STN

• Baseline: 43 ± 15

• Post DBS: 32.1 ± 15.6

GPi

• Baseline: 41.8 ± 13.1

• Post DBS: 30 ± 14.2

• 25.3% improvement in UPDRS III

• Improvement in 6 of 8 subscales

Rodriquez-

Oroz 2005⁶

Multi-center

study

 69 3-4 yrs.

STN

• Baseline: 56.7 ± 15.7

• Post DBS: 28.6 ± 15.7

GPi

• Baseline: 51.7 ± 13.6

• Post DBS: 31.7 ± 12.8

• 50% improvement in UPDRS III

with STN and 39% improvement

with GPi at 3-4 yrs.

Gervais-

Bernard 2009⁷

Prospective,

single-center

 23 5 yrs.

Baseline: 43.11 ± 14.04

• Post DBS: 19.52 ± 7.17

 • 55% improvement in UPDRS III
Moro 2010⁸

Nonrandomized,

prospect,

blinded, multicenter

study

 51 5-6 yrs.

STN

• Baseline: 56 ± 2.7

• Post DBS: 30.1 ± 2.5

GPi

• Baseline: 52.2 ± 3.5

• Post DBS: 32.6 ± 4.6

• 45.4 (STN) to 20% (GPi)

improvement in UPDRS III
  1. Deuschl G , Schade-Brittinger C et al. A Randomized Trial of Deep-Brain Stimulation for Parkinson’s Disease. N Engl J Med 2006;355:896-908.
  2. Tir M, Exhaustive, one-year follow-up of subthalamic nucleus deep brain stimulation in a large, single-center cohort of Parkinson’s patients, Neurosurgery 61:297–305, 2007.
  3. Fraix V, Houeto JL, Lagrange C et al. Clinical and economic results of bilateral subthalamic nucleus stimulation in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2006;77:443–449.
  4. Lafaucheur JP, Gurruchaga JM, Pollin B et al. Outcome of Bilateral Subthalamic Nucleus Stimulation in the Treatment of Parkinson’s Disease: Correlation with Intra-Operative Multi-Unit Recordings but Not with the Type of Anaesthesia. Eur Neurol 2008;60:186–199.
  5. Follett KA, Weaver FM, Stern M et al. Pallidal versus Subthalamic Deep-Brain Stimulation for Parkinson’s Disease. N Engl J Med 2010;362:2077-91.
  6. Rodriguez-Oroz MC, Bilateral deep brain stimulation in Parkinson’s disease: a multicentre study with 4 years follow-up, Brain (2005), 128, 2240–2249.
  7. Gervais-Bernard H, Xie-Brustolin J, Mertens P et al, Bilateral subthalamic nucleus stimulation in advanced Parkinson’s disease: Five year follow-up. J Neurol (2009) 256:225–233.
  8. Moro E, Lozano A, Pollak P et al. Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson’s Disease. Movement Disorders Vol. 25, No. 5, 2010, pp. 578–586 1.
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