Bilateral Deep Brain Stimulation vs Best Medical Therapy for Patients With Advanced Parkinson Disease A Randomized Controlled Trial

Patients receiving bilateral deep brain stimulation gained a mean of 4.6 hours per day of on time without troubling dyskinesia at 6 months, compared with no change in the best medical therapy group.

Effect: improvement; 4.6 h/d gain (DBS) vs 0 h/d (BMT); between-group difference 4.5 h/d; CI: 95% CI, 3.7-5.4 h/d

Off-medication UPDRS motor scores improved by 12.3 points in the DBS group versus 1.7 points in the best medical therapy group at 6 months based on blinded assessments, with 71% of DBS patients versus

Effect: improvement; -12.3 points (DBS) vs -1.7 points (BMT) on UPDRS motor score

Patients receiving deep brain stimulation experienced significant improvements on the PDQ-39 summary measure and 7 of 8 subscales compared with best medical therapy at 6 months.

Effect: improvement; Significant improvement on PDQ-39 summary measure and 7 of 8 subscales

Deep brain stimulation was associated with small but statistically significant decrements in working memory, processing speed, phonemic fluency, and visuospatial delayed recall compared with best medi

Effect: adverse; 1.0 to 3.5-point decreases in DBS group vs 1 to 2-point increases in BMT group on composite measures

The overall incidence risk of experiencing a serious adverse event was 3.8 times higher in DBS patients than in BMT patients, with 49 DBS patients (40%) experiencing at least 1 serious adverse event c

Effect: adverse; Incidence risk ratio 3.8 (DBS vs BMT); 40% of DBS patients vs 11% of BMT patients experienced at least 1 serious adverse event; CI: 95% CI, 2