Comparison of Subthalamic Nucleus and Globus Pallidus Internus Deep Brain Stimulation Surgery on Parkinson Disease–Related Pain

Gong, Shusheng; Xu, Menting; Tao, Yingqun; Jin, Hai; Yang, Le; Sun, Xiao; Wang, Shimiao; Yang, Xiaotao; Wang, Yu; Yuan, Lijia; Song, Weilong

doi:10.1016/j.wneu.2019.11.026

Cited by 12 publications

(11 citation statements)

References 28 publications

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“…In this study, we believe that both unilateral and bilateral DBS have curative effects on PD-related pain. Some studies have suggested that both sides can improve the motor symptoms of a patient and symptom fluctuations; therefore, DBS is effective for PD-related pain affected by motor symptoms (Conte et al, 2013 ; Gong et al, 2020 ). Some animal studies also suggest that regardless of whether it is bilateral or unilateral, STN-DBS increases mechanical thresholds and offers improvements to chronic pain in patients with PD (Sung et al, 2018 ; Kaszuba et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of the Effect of Subthalamic Nucleus-Deep Brain Stimulation in Parkinson's Disease-Related Pain

Diao

Bai

et al. 2021

Front. Hum. Neurosci.

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Pain from Parkinson's disease (PD) is a non-motor symptom affecting the quality of life and has prevalence of 20–80%. However, it is unclear whether subthalamic nucleus deep brain stimulation (STN–DBS), a well-established treatment for PD, is effective forPD-related pain. Thus, the objective of this meta-analysis was to investigate the efficacy of STN-DBS on PD-related pain and explore how its duration affects the efficacy of STN-DBS. A systematic search was performed using PubMed, Embase, and the Cochrane Library. Nine studies included numerical rating scale (NRS), visual analog scale (VAS), or non-motor symptom scale (NMSS) scores at baseline and at the last follow-up visit and therefore met the inclusion criteria of the authors. These studies exhibited moderate- to high-quality evidence. Two reviewers conducted assessments for study eligibility, risk of bias, data extraction, and quality of evidence rating. Random effect meta-analysis revealed a significant change in PD-related pain as assessed by NMSS, NRS, and VAS (P <0.01). Analysis of the short and long follow-up subgroups indicated delayed improvement in PD-related pain. These findings (a) show the efficacy of STN-DBS on PD-related pain and provide higher-level evidence, and (b) implicate delayed improvement in PD-related pain, which may help programming doctors with supplement selecting target and programming.Systematic Review Registration: This study is registered in Open Science Framework (DOI: 10.17605/OSF.IO/DNM6K).

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Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of the Effect of Subthalamic Nucleus-Deep Brain Stimulation in Parkinson's Disease-Related Pain

Diao

Bai

et al. 2021

Front. Hum. Neurosci.

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“…(28) In another study conducted by Odekerken et al, more improvements were reported the off-drug phase UPDRS-ME score after three years in the STN group (p = 0.04 while no between-group differences were shown in the on-drug phase (27). In the study of Gong et al, four months after DBS, all patients experienced improvement (≥ 30% ) in UPDRS score in off-period, and pain symptoms improvement rate was 79 ± 27% and 75%±27% in STN and GPi groups, respectively (29). Fan et al…”

Section: Study Characteristicsmentioning

confidence: 88%

Comparison of subthalamic nucleus and globus pallidus deep brain stimulation in patients with Parkinson's disease: A systematic review of literature

Azari

2021

Preprint

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Background: Deep brain stimulation (DBS) is regarded as a viable therapeutic choice for Parkinson's disease (PD). The two most common sites for DBS are the subthalamic nucleus (STN) and globus pallidus (GPi). In this study, the clinical effectiveness of these two targets was compared.Methods: A systematic literature search in electronic databases were restricted to English language publications 2010 to 2021. Specified MeSH terms were searched in all databases. Studies that evaluated the Unified Parkinson's Disease Rating Scale (UPDRS) III were selected by meeting the following criteria: (1) had at least three months follow-up period; (2) compared both GPi and STN DBS; (3)at least five participants in each group; (4)conducted after 2010. Study quality assessment was performed using the Modified Jadad Scale.Results: 3577 potentially relevant articles were identified,3569 were excluded based on title and abstract, duplicate and unsuitable article removal. Eight articles satisfied the inclusion criteria and were scrutinized (458 PD patients). Majority of studies reported no statistically significant between-group difference for improvements in UPDRS ш scores.Conclusions: Although there were some results in terms of action tremor, rigidity, and urinary symptoms, which indicated that STN DBS might be a better choice or regarding the adverse effects, GPi seemed better; but it cannot be concluded that one target is superior. Other larger randomized clinical trials with longer follow-up periods and control groups are needed to decide which target is more efficient for stimulation and imposes fewer adverse effects on the patients.

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“…As the frequency of spontaneous blinking increased, the perception of pain decreased. In this regard, abnormal pain perception has been observed both in animal models 24,54,55 and human pathological conditions characterized by a reduction in central dopaminergic tone 16,17,56,57 , such as depression and PD. Moreover, recent pharmacological studies strongly support the role of dopamine in antinociception.…”

Section: Discussionmentioning

confidence: 99%

Painful stimulation increases spontaneous blink rate in healthy subjects

Paparella

Stefano

Fasolino

et al. 2020

Sci Rep

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Spontaneous blink rate is considered a biomarker of central dopaminergic activity. Recent evidence suggests that the central dopaminergic system plays a role in nociception. In the present study, we aimed to investigate whether pain modulates spontaneous blink rate in healthy subjects. We enrolled 15 participants. Spontaneous blink rate was quantified with an optoelectronic system before and after: (1) a painful laser stimulation, and (2) an acoustic startling stimulation. In control experiments, we investigated whether laser stimulation effects depended on stimulation intensity and whether laser stimulation induced any changes in the blink reflex recovery cycle. Finally, we investigated any relationship between spontaneous blink rate modification and pain modulation effect during the cold pressor test. Laser, but not acoustic, stimulation increased spontaneous blink rate. This effect was independent of stimulation intensity and negatively correlated with pain perception. No changes in trigeminal-facial reflex circuit excitability were elicited by laser stimulation. The cold pressor test also induced an increased spontaneous blink rate. Our study provides evidence on the role of dopamine in nociception and suggests that dopaminergic activity may be involved in pain modulation. These findings lay the groundwork for further investigations in patients with pathological conditions characterized by dopaminergic deficit and pain.

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Comparison of Subthalamic Nucleus and Globus Pallidus Internus Deep Brain Stimulation Surgery on Parkinson Disease–Related Pain

Cited by 12 publications

References 28 publications

A Meta-Analysis of the Effect of Subthalamic Nucleus-Deep Brain Stimulation in Parkinson's Disease-Related Pain

A Meta-Analysis of the Effect of Subthalamic Nucleus-Deep Brain Stimulation in Parkinson's Disease-Related Pain

Comparison of subthalamic nucleus and globus pallidus deep brain stimulation in patients with Parkinson's disease: A systematic review of literature

Painful stimulation increases spontaneous blink rate in healthy subjects

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