Deep brain stimulation (DBS) in movement disorders management: exploring therapeutic efficacy, neurobiological mechanisms, and clinical implications.

INTRODUCTION

Deep brain stimulation (DBS) has emerged as a promising therapeutic approach, offering targeted neuromodulation for movement disorders refractory to medical management or stereotactic surgery. However, assessing its benefits against potential risks is essential. This meta-analysis aims to evaluate the efficacy and safety of DBS in movement disorders, shedding light on its role as an alternative therapeutic option.

METHODS

A comprehensive search of databases after systemic review yielded studies published in English from 2000 to the present. Data selection, screening, extraction, and risk of bias assessment were performed meticulously. Statistical analysis was conducted using RevMan 2.0, with significant heterogeneity addressed through appropriate methods.

RESULTS

Our meta-analysis included 40 studies assessing the Unified Parkinson's Disease Rating Scale Part III, revealing a significant improvement in motor symptoms (mean difference [MD]: -18.05, 95% confidence interval [CI] [-20.17, -15.93], P < 0.00001). Hoehn and Yahr Stage analysis demonstrated a reduction in disease severity (MD: -0.58, 95% CI [-1.05, -0.12], P = 0.01). Tremor severity (MD: -8.22, 95% CI [-12.30, -4.15], P < 0.0001), overall tremor (MD: -2.68, 95% CI [-4.59, -0.77], P = 0.006), gait velocity (MD: 0.13, 95% CI [0.08, 0.18], P < 0.00001), and Yale Global Tic Severity Scale score (MD: -9.75, 95% CI [-14.55, -4.96], P < 0.0001) also showed significant improvements with DBS.

CONCLUSION

DBS demonstrates efficacy in improving motor symptoms, disease severity, tremor, gait, and tic severity in movement disorders. However, further research is needed to elucidate long-term efficacy and safety outcomes.