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.

尽管苍白球内部 (GPi) 和丘脑底核 (STN) 的深部脑刺激 (DBS) 已成为帕金森病 (PD) 的既定治疗方法，但缺乏最近对结果的荟萃分析。为了弥补这一差距，我们对 1990-08/2019 发表的双边 STN-和 GPi-DBS 研究进行了荟萃分析。包括≥10 名受试者在基线和 6-12 个月随访时报告统一帕金森病评定量表 (UPDRS) III 运动评分的研究。分析了几个结果变量并总结了不良事件 (AE)。39 项 STN 研究（2035 名受试者）和 5 项 GPi 研究（292 名受试者）符合条件。与术前药物关闭状态相比，手术后刺激开启/药物关闭状态下的 UPDRS-II 评分使用 STN-DBS 提高了 47%，使用 GPi-DBS 提高了 18.5%。UPDRS-III 评分提高了 50。STN-DBS 为 5%，GPi-DBS 为 29.8%。STN-DBS 将运动障碍改善了 64%，每日关闭时间增加了 69.1%，PDQ-39 测量的生活质量改善了 22.2%，而左旋多巴等效每日剂量 (LEDD) 减少了 50.0%。对于有关运动障碍、关闭时间、PDQ-39 和 LEDD 的 GPi-DBS 信息，不足以进行进一步分析。相关性分析表明，在所有研究中，术前左旋多巴反应性对 STN-DBS 运动结果具有高度预测性。最常见的手术相关 AE 是感染 (5.1%) 和颅内出血 (3.1%)。尽管取得了一系列技术进步，但现代手术的结果仍可与 DBS 早期的结果相媲美。