Apathy following Bilateral Deep Brain Stimulation of Subthalamic Nucleus and Globus Pallidus Internus in Parkinson’s Disease: A Meta-Analysis
Parkinson’s disease (PD) is a progressive neurodegenerative disorder typically manifested by its motor symptoms. In addition, PD patients also suffer from many nonmotor symptoms (NMSs), such as apathy. Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the globus pallidus in...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Parkinson's Disease |
| Online Access: | http://dx.doi.org/10.1155/2022/4204564 |
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| author | Song Zhang Shumei Zi Sihuai Xiong Heng Peng Kejia Hu Hua He |
| author_facet | Song Zhang Shumei Zi Sihuai Xiong Heng Peng Kejia Hu Hua He |
| author_sort | Song Zhang |
| collection | DOAJ |
| description | Parkinson’s disease (PD) is a progressive neurodegenerative disorder typically manifested by its motor symptoms. In addition, PD patients also suffer from many nonmotor symptoms (NMSs), such as apathy. Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the globus pallidus internus (GPi) are recommended as therapeutic interventions for PD, given their pronounced benefit in reducing troublesome dyskinesia. Apathy, a mood disorder recognized as a NMS of PD, has a negative impact on the prognosis of PD patients. However, the effect of STN-DBS and GPi-DBS on apathy is controversial. In the current meta-analysis, we analyzed apathy following bilateral STN-DBS and GPi-DBS in PD patients. Relevant literature was retrieved from public databases, including PubMed, Cochrane Library, and Embase. Studies were included in our analysis based on the following criterion: such studies should report apathy scores presurgery and postsurgery determined by using the Starkstein Apathy Scale or Apathy Evaluation Scale in patients receiving STN or GPi-DBS with at least three months of follow-up. Upon applying this strict criterion, a total of 13 out of 302 studies were included in our study. A mean difference (MD) and 95% confidence interval (CI) were calculated to show the change in apathy scores. We found a statistically significant difference between the presurgery and postsurgery scores in patients receiving STN-DBS (MD = 2.59, 95% CI = 2.23–2.96, P<0.00001), but not in patients receiving GPi-DBS (MD = 0.32, 95% CI = −2.78–3.41, P=0.84). STN-DBS may worsen the condition of apathy, which may result from the reduction of dopaminergic medication. In conclusion, STN-DBS seems to relatively worsen the condition of apathy compared to GPi-DBS. Further studies should focus on the mechanisms of postoperatively apathy and the degree of apathy in STN-DBS versus GPi-DBS. |
| format | Article |
| id | doaj-art-c609a596df9944258df2f32f215f61ba |
| institution | OA Journals |
| issn | 2042-0080 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Parkinson's Disease |
| spelling | doaj-art-c609a596df9944258df2f32f215f61ba2025-08-20T02:18:38ZengWileyParkinson's Disease2042-00802022-01-01202210.1155/2022/4204564Apathy following Bilateral Deep Brain Stimulation of Subthalamic Nucleus and Globus Pallidus Internus in Parkinson’s Disease: A Meta-AnalysisSong Zhang0Shumei Zi1Sihuai Xiong2Heng Peng3Kejia Hu4Hua He5Departments of NeurosurgeryCollege of EcologyDepartments of NeurosurgeryDepartment of MathematicsDepartment of NeurosurgeryDepartments of NeurosurgeryParkinson’s disease (PD) is a progressive neurodegenerative disorder typically manifested by its motor symptoms. In addition, PD patients also suffer from many nonmotor symptoms (NMSs), such as apathy. Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the globus pallidus internus (GPi) are recommended as therapeutic interventions for PD, given their pronounced benefit in reducing troublesome dyskinesia. Apathy, a mood disorder recognized as a NMS of PD, has a negative impact on the prognosis of PD patients. However, the effect of STN-DBS and GPi-DBS on apathy is controversial. In the current meta-analysis, we analyzed apathy following bilateral STN-DBS and GPi-DBS in PD patients. Relevant literature was retrieved from public databases, including PubMed, Cochrane Library, and Embase. Studies were included in our analysis based on the following criterion: such studies should report apathy scores presurgery and postsurgery determined by using the Starkstein Apathy Scale or Apathy Evaluation Scale in patients receiving STN or GPi-DBS with at least three months of follow-up. Upon applying this strict criterion, a total of 13 out of 302 studies were included in our study. A mean difference (MD) and 95% confidence interval (CI) were calculated to show the change in apathy scores. We found a statistically significant difference between the presurgery and postsurgery scores in patients receiving STN-DBS (MD = 2.59, 95% CI = 2.23–2.96, P<0.00001), but not in patients receiving GPi-DBS (MD = 0.32, 95% CI = −2.78–3.41, P=0.84). STN-DBS may worsen the condition of apathy, which may result from the reduction of dopaminergic medication. In conclusion, STN-DBS seems to relatively worsen the condition of apathy compared to GPi-DBS. Further studies should focus on the mechanisms of postoperatively apathy and the degree of apathy in STN-DBS versus GPi-DBS.http://dx.doi.org/10.1155/2022/4204564 |
| spellingShingle | Song Zhang Shumei Zi Sihuai Xiong Heng Peng Kejia Hu Hua He Apathy following Bilateral Deep Brain Stimulation of Subthalamic Nucleus and Globus Pallidus Internus in Parkinson’s Disease: A Meta-Analysis Parkinson's Disease |
| title | Apathy following Bilateral Deep Brain Stimulation of Subthalamic Nucleus and Globus Pallidus Internus in Parkinson’s Disease: A Meta-Analysis |
| title_full | Apathy following Bilateral Deep Brain Stimulation of Subthalamic Nucleus and Globus Pallidus Internus in Parkinson’s Disease: A Meta-Analysis |
| title_fullStr | Apathy following Bilateral Deep Brain Stimulation of Subthalamic Nucleus and Globus Pallidus Internus in Parkinson’s Disease: A Meta-Analysis |
| title_full_unstemmed | Apathy following Bilateral Deep Brain Stimulation of Subthalamic Nucleus and Globus Pallidus Internus in Parkinson’s Disease: A Meta-Analysis |
| title_short | Apathy following Bilateral Deep Brain Stimulation of Subthalamic Nucleus and Globus Pallidus Internus in Parkinson’s Disease: A Meta-Analysis |
| title_sort | apathy following bilateral deep brain stimulation of subthalamic nucleus and globus pallidus internus in parkinson s disease a meta analysis |
| url | http://dx.doi.org/10.1155/2022/4204564 |
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