Ameliorating motor performance and quality of life in Parkinson's disease: a comparison of deep brain stimulation and focused ultrasound surgery.

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Frontiers in Neurology Pub Date : 2025-04-30 eCollection Date: 2025-01-01 DOI:10.3389/fneur.2025.1449973

Mingqian Liang, Le Hou, Jinjun Liang, Shengyong Bao

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引用次数: 0

Abstract

Introduction: Deep brain stimulation (DBS) and magnetic resonance-guided focused ultrasound surgery (MRgFUS) have emerged as valuable treatment options for Parkinson's disease (PD) with drug-resistant symptoms. However, comparative studies of various DBS targets and MRgFUS are still limited.

Methods: We reviewed three databases for trials on the effects of DBS or MRgFUS on PD patients, focusing on motor performance and quality of life (QoL). A frequentist network meta-analysis was conducted to estimate the treatment effects.

Results: There were 39 trials in this study, comprising 3,002 patients. In the off-phase, subthalamic nucleus_DBS (STN_DBS [SMD, -0.94; 95%CI, -1.40 to -0.48]) significantly improved the UPDRS-III Total score compared to medication treatment alone (MT). In the on-phase, STN_DBS (SMD, -0.83; 95%CI, -1.13 to -0.53), internal globus pallidus_DBS (GPi_DBS [SMD, -0.80; 95%CI, -1.20 to -0.40]), and STN_Focused Ultrasound (STN_FUS [SMD, -1.83; 95%CI, -2.97 to -0.68]) significantly improved the UPDRS-III Total score. Regarding QoL, STN_DBS (SMD, -0.75; 95% CI, -1.46 to -0.05) and GPi_DBS (SMD, -0.58; 95% CI, -0.96 to -0.21) demonstrated better outcomes compared to MT. The SUCRA plot indicated that the top three treatments for UPDRS-III Total score in the off-phase were STN_FUS (79.6%), STN-GPi_DBS (73.7%), and STN_DBS (69.1%). In the on-phase, the top three treatments were STN_FUS (95.7%), STN_DBS (69.6%), and GPi_DBS (66.9%). Regarding QoL, GPi_DBS (77.2%) ranks first, followed by STN_DBS (67.3%), STN_FUS (56.9%) ranks third.

Conclusion: STN_DBS, GPi_DBS, and STN_FUS have exhibited efficacy in ameliorating motor performance and enhancing QoL in PD patients. Nevertheless, as a potential alternative to STN_DBS with comparable efficacy, STN-FUS may serve as another treatment option.

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改善帕金森病患者的运动表现和生活质量：深部脑刺激和聚焦超声手术的比较

脑深部刺激（DBS）和磁共振引导聚焦超声手术（MRgFUS）已成为具有耐药症状的帕金森病（PD）的有价值的治疗选择。然而，各种DBS靶点和MRgFUS的比较研究仍然有限。方法：我们回顾了三个数据库，以研究DBS或MRgFUS对PD患者的影响，重点关注运动表现和生活质量（QoL）。采用频率网络元分析来估计治疗效果。结果：本研究共纳入39项试验，包括3002例患者。非相时，丘脑底核- dbs (STN_DBS [SMD, -0.94；（95%CI, -1.40 ~ -0.48）)与单纯药物治疗（MT）相比，UPDRS-III总分显著提高。在on相中，STN_DBS (SMD, -0.83；95%CI, -1.13 ~ -0.53)，内部苍白球dbs (GPi_DBS [SMD, -0.80；95%CI, -1.20 ~ -0.40]), STN_Focused Ultrasound (STN_FUS [SMD, -1.83；（95%CI, -2.97 ~ -0.68）)显著提高了UPDRS-III总分。QoL方面，STN_DBS (SMD, -0.75；95% CI, -1.46 ~ -0.05)和GPi_DBS (SMD, -0.58；95% CI, -0.96至-0.21)显示出与MT相比更好的结果。SUCRA图显示，非期UPDRS-III总评分前三名的治疗是STN_FUS (79.6%), STN-GPi_DBS（73.7%）和STN_DBS（69.1%）。在非期治疗中，前三名分别是STN_FUS（95.7%）、STN_DBS（69.6%）和GPi_DBS（66.9%）。生活质量方面，GPi_DBS排名第一（77.2%），其次是STN_DBS (67.3%)， STN_FUS排名第三（56.9%）。结论：STN_DBS、GPi_DBS和STN_FUS具有改善PD患者运动能力和提高生活质量的作用。然而，作为STN_DBS的潜在替代方案，STN-FUS可以作为另一种治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Neurology CLINICAL NEUROLOGYNEUROSCIENCES -NEUROSCIENCES

CiteScore

4.90

自引率

8.80%

发文量

2792

审稿时长

14 weeks

期刊介绍： The section Stroke aims to quickly and accurately publish important experimental, translational and clinical studies, and reviews that contribute to the knowledge of stroke, its causes, manifestations, diagnosis, and management.