Deep Brain Stimulation of the Globus Pallidus Internus and Externus in Multiple System Atrophy

Author:

Di Luca Daniel G.1234ORCID,Ramirez‐Gomez Carolina12,Germann Jurgen5,Santyr Brendan5ORCID,Boutet Alexandre6ORCID,Milosevic Luka78910,Lang Anthony E.19ORCID,Kalia Suneil K.5910,Lozano Andres M.5910,Fasano Alfonso12910ORCID

Affiliation:

1. Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic Toronto Western Hospital, UHN Toronto Ontario Canada

2. Division of Neurology University of Toronto Toronto Ontario Canada

3. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada

4. Department of Neurology Washington University in St. Louis St. Louis Missouri USA

5. Department of Surgery University of Toronto Toronto Ontario Canada

6. Department of Medical Imaging University of Toronto Toronto Ontario Canada

7. Institute of Biomedical Engineering University of Toronto Toronto Ontario Canada

8. Institute of Medical Sciences University of Toronto Toronto Ontario Canada

9. Krembil Brain Institute Toronto Ontario Canada

10. Center for Advancing Neurotechnological Innovation to Application Toronto Ontario Canada

Abstract

AbstractBackgroundMultiple system atrophy with parkinsonism (MSA‐P) is a progressive condition with no effective treatment.ObjectiveThe aim of this study was to describe the safety and efficacy of deep brain stimulation (DBS) of globus pallidus pars interna and externa in a cohort of patients with MSA‐P.MethodsSix patients were included. Changes in Movement Disorders Society Unified Parkinson's Disease Rating Scale Part III (MDS‐UPDRS III), Parkinson's Disease Questionnaire (PDQ‐39) scores, and levodopa equivalent daily dose were compared before and after DBS. Electrode localization and volume tissue activation were calculated.ResultsDBS surgery did not result in any major adverse events or intraoperative complications. Overall, no differences in MDS‐UPDRS III scores were demonstrated (55.2 ± 17.6 preoperatively compared with 67.3 ± 19.2 at 1 year after surgery), although transient improvement in mobility and dyskinesia was reported in some subjects.ConclusionsGlobus pallidus pars interna and externa DBS for patients with MSA‐P did not result in major complications, although it did not provide significant clinical benefit as measured by MDS‐UPDRS III. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Funder

Multiple System Atrophy Coalition

Publisher

Wiley

Subject

Neurology (clinical),Neurology

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