The Effects of Deep Brain Stimulation on Mood and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis

Abstract

Deep brain stimulation (DBS) is extensively used to treat motor andnon-motor symptoms in Parkinson's disease (PD). The aim of this study wasto investigate the difference between subthalamic (STN) and globuspallidus internus (GPi) DBS on mood and quality of life with reference tominimal clinically important differences (MCID). A systematic literaturesearch for articles published until November 2022 yielded 14 studiesmeeting the eligibility criteria, with a total of 1,088 patientsundergoing STN (n=571) or GPi (n=517) stimulation. Baseline patient andclinical characteristics were comparable between the two groups. Resultsshowed that GPi stimulation demonstrated a greater reduction in the Beckdepression inventory (mean difference (MD)=1.68) than STN stimulation(MD=0.84). Hospital anxiety and depression scale showed a 2.69- and3.48-point decrease by the GPi group in the depression and anxietycategories, respectively. The summary index (SI) of the PD questionnairedepicted a greater improvement in the GPi group from baseline (mean=41.01,95% CI 34.89, 47.13) to follow-up (mean=30.85, 95% CI 22.08, 39.63) whencompared to the STN group (baseline mean=42.43, 95% CI 34.50, 50.37;follow-up mean=34.21, 95% CI 25.43, 42.99). The emotions category alsodemonstrated a similar trend. However, STN stimulation showed greaterreductions in motor symptoms and medication than GPi stimulation. Thismeta-analysis demonstrated that GPi stimulation seems to offer anadvantage over STN stimulation in improving mood and quality of life inPD, but those effects must be further validated by larger studies.Copyright © 2023, El Ghazal et al.