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Therapeutic impact of brain stimulation on motor and non-motor symptoms in Parkinson's disease: a systematic review and meta-analysis

Therapeutic impact of brain stimulation on motor and non-motor symptoms in Parkinson's disease: a systematic review and meta-analysis

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Original abstract

Parkinson's disease (PD) significantly impacts motor and non-motor functions, necessitating innovative therapies beyond medication. Deep brain stimulation (DBS) showed promise in improving motor symptoms and quality of life. This study aimed to evaluate their efficacy, safety, and comparative benefits to inform personalized, evidence-based PD treatment strategies. This systematic review and meta-analysis followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, Embase, and Cochrane databases was conducted. Data on motor/non-motor outcomes, quality of life, and complications were extracted. Random-effects models assessed pooled effect sizes, heterogeneity, and publication bias. A total of 33 studies were included. DBS significantly improved motor symptoms based on Unified Parkinson's Disease Rating Scale part III (UPDRS III) (MD = −10.6550, p < 0.0001), particularly with caudal zona incerta (cZi) and globus pallidus internus targets, while subthalamic nucleus (STN) also showed robust results. Improvements in activities of daily living based on UPDRS part II were noted but not significant. Non-motor symptoms based on UPDRS part I and axial signs showed minimal improvement. Adverse events occurred in 26.37% of cases. DBS significantly improved motor symptoms in PD, while effects on non-motor symptoms remained limited. Careful patient selection and long-term follow-up are essential.

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