PMID- 30153572
OWN - NLM
STAT- MEDLINE
DCOM- 20190723
LR  - 20190723
IS  - 1878-5883 (Electronic)
IS  - 0022-510X (Linking)
VI  - 393
DP  - 2018 Oct 15
TI  - Persistent adverse effects following different targets and periods after 
      bilateral deep brain stimulation in patients with Parkinson's disease.
PG  - 116-127
LID - S0022-510X(18)30336-8 [pii]
LID - 10.1016/j.jns.2018.08.016 [doi]
AB  - BACKGROUND: Performed as one of the major treatments for advanced Parkinson's 
      disease (PD), deep brain stimulation (DBS) surgery can induce adverse effects 
      (AEs) on cognition, gait, mood, speech and swallowing, which are frequently 
      reported and seriously affect the patient's daily life. OBJECTIVE: To 
      comprehensively analysis the adverse effect rates (AERs) of cognition, mood, 
      gait, speech and swallowing after bilateral DBS in patients with PD. METHOD: We 
      performed a systematic search in PubMed, EMBASE and the Cochrane Library to 
      collect all the articles reporting AEs after DBS in sufferers of PD. The cited 
      articles were also manually searched. RESULTS: A total of 31 articles were 
      quantitatively analyzed. Random-effects models were used to calculate the AERs 
      and 95% confidence intervals. Of all patients, the pooled AER of the five types 
      of events was 24.0%. Specifically, the risks of cognition, mood and speech 
      disturbance were higher after subthalamic nucleus (STN) -DBS than after globus 
      pallidus interna (GPi) -DBS: 25.1% versus 14.6%, 26.3% versus 22.2% and 29.0% 
      versus 19.6%, respectively. However, the AER of dysphagia was slightly lower 
      after STN-DBS: 8.6% versus 10.1%. The risk of gait disorders was similar between 
      two target groups in sub-analysis of random control trials (RCTs): 38.3% in STN 
      group and 37.3% in GPi group. In three follow-up intervals, short-term follow-up 
      (STF), mid-term follow-up (MTF) and long-term follow-up (LTF), gait 
      (17.6%~19.9%~28.0%), speech (7.8%~26.9%~31.5%) and mood (7.4%~24.9%~30.7%) 
      disorders worsened progressively. While cognitive disturbance (22.5%~27.1%~16.7%) 
      reached its highest rate at MTF. CONCLUSION: STN-DBS was 10% more likely to cause 
      cognitive and speech disturbance than GPi-DBS, while STN-DBS had a lower risk of 
      dysphagia. Two target groups had similar effects on gait. The pooled AER 
      increased over time, while cognitive disturbance reached its highest rate at the 
      6- to 18-month follow-up. Additionally, speech and mood disturbance deteriorated 
      rapidly from STF to MTF. Further investigation of the pathophysiology will help 
      alleviate those AEs after DBS.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Yin, Zixiao
AU  - Yin Z
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China; The First Clinical Medical College of Nanchang University, 
      Nanchang, China. Electronic address: zixiao_yin@163.com.
FAU - Cao, Yuan
AU  - Cao Y
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China; The First Clinical Medical College of Nanchang University, 
      Nanchang, China.
FAU - Zheng, Suyue
AU  - Zheng S
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Duan, Jian
AU  - Duan J
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Zhou, Dongwei
AU  - Zhou D
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Xu, Renxu
AU  - Xu R
AD  - Department of Neurology, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Hong, Tao
AU  - Hong T
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Lu, Guohui
AU  - Lu G
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, China. Electronic address: guohui-lu@163.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20180818
PL  - Netherlands
TA  - J Neurol Sci
JT  - Journal of the neurological sciences
JID - 0375403
MH  - Deep Brain Stimulation/*adverse effects
MH  - Humans
MH  - Parkinson Disease/*therapy
OTO - NOTNLM
OT  - Adverse effects
OT  - Deep brain stimulation
OT  - Globus pallidus internus
OT  - Parkinson's disease
OT  - Subthalamic nucleus
EDAT- 2018/08/29 06:00
MHDA- 2019/07/25 06:00
CRDT- 2018/08/29 06:00
PHST- 2017/12/05 00:00 [received]
PHST- 2018/06/22 00:00 [revised]
PHST- 2018/08/14 00:00 [accepted]
PHST- 2018/08/29 06:00 [pubmed]
PHST- 2019/07/25 06:00 [medline]
PHST- 2018/08/29 06:00 [entrez]
AID - S0022-510X(18)30336-8 [pii]
AID - 10.1016/j.jns.2018.08.016 [doi]
PST - ppublish
SO  - J Neurol Sci. 2018 Oct 15;393:116-127. doi: 10.1016/j.jns.2018.08.016. Epub 2018 
      Aug 18.