title: GPi and STN deep brain stimulation can suppress dyskinesia in Parkinson's disease.
abstract: OBJECTIVE
  To compare subthalamic nucleus (STN) to globus pallidus internus (GPi) deep brain stimulation (DBS) for control of motor fluctuations and for potential dyskinesia-suppressing qualities.
  
  
  METHODS
  We conducted a retrospective database review of all patients who underwent GPi or STN DBS for idiopathic Parkinson's disease. Direct dyskinesia suppression (dDS) was defined as improvement in dyskinesia subscore of the unified Parkinson's disease rating scale (UPDRS) part IV (items 32-34), despite lack of reduction in dopaminergic medication dosage. We analyzed the data using methods appropriate for a case-control study.
  
  
  RESULTS
  A total of 133 patients were evaluated. At the last evaluation Dyskinesia scores and motor fluctuations significantly improved in both the GPi (p < 0.0001) and STN groups (p < 0.0001). The GPi group was more likely than the STN group to experience dDS (odds ratio = 1.95, 95% CI = 0.556, 3.21). However, the association between DBS target and dDS was not statistically significant (Pearson chi-square = 2.286, p = 0.131).
  
  
  CONCLUSIONS
  The overall clinical outcome of STN and GPi DBS for control of dyskinesia and motor fluctuations was similar. STN and GPi DBS both had some direct dyskinesia suppression effects.
authors.affiliation: Department of Neurology, Center for Movement Disorders & Neurorestoration, University of Florida, FL 32610, USA.
authors.forename: Genko
authors.initials: G
authors.lastname: Oyama
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Foote
authors.forename: Charles E
authors.initials: CE
authors.lastname: Jacobson
authors.forename: Frances
authors.initials: F
authors.lastname: Velez-Lago
authors.forename: Criscely
authors.initials: C
authors.lastname: Go
authors.forename: Natlada
authors.initials: N
authors.lastname: Limotai
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Zeilman
authors.forename: Janet
authors.initials: J
authors.lastname: Romrell
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Wu
authors.forename: Dan
authors.initials: D
authors.lastname: Neal
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D046690:Deep Brain Stimulation / Q000379:methods; D020820:Dyskinesias / Q000209:etiology / Q000628:therapy*; D005260:Female; D005917:Globus Pallidus / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D020531:Subthalamic Nucleus / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome