The Efficacy of Deep Brain Stimulation in Parkinson’s Disease Treatment: A Systematic Review

Abstract

Background: Deep brain stimulation (DBS) is a promising adjuvant therapy for Parkinson’s disease (PD) in intermediate and advanced states, improving motor symptoms and life quality. Objectives: To investigate the efficacy of DBS in PD treatment. Design and Setting: Systematic review performed on medical school in Brazil. Methods: A literature review in the MedLine database was conducted using the following descriptors: “Deep Brain Stimulation”, “Parkinson’s Disease” and its variations according to MeSH. Only randomized controlled trials conducted in humans and published in English in the last 10 years were included. The PRISMA statement was used to improve this systematic review’s findings. Results: Three clinical trials that evaluated the effects of DBS in PD’s management were analysed. The main result measurement tools used in the studies were the PDQ-39-SI and UPDRS-III scores. Hacked ML et al. (2018) concluded that drug therapy + DBS was significantly superior to isolated drug therapy (p <0.0002). Schuepbach WMM et al. (2019) found that the experimental group presented significantly better outcomes in comparison to the control group (p <0,05). Birchall EL et al. (2016) suggested that the DBS device implant in the subthalamic nucleus caused significant improvement in depressive symptoms, motor symptoms, quality of sleep (p <0.0001) and quality of life (p=0.0005) in comparison to the control group. Conclusions: DBS has shown to be an efficient therapy for PD, once it promoted better outcomes regarding motor symptoms, depression, quality of life and quality of sleep. However, it is necessary to be aware of eventual side effects in the post-operative period.