Deep Brain Stimulation of the Globus Pallidus Internus and Externus in Multiple System Atrophy

Mov Disord. 2023 Nov;38(11):2121-2125. doi: 10.1002/mds.29573. Epub 2023 Aug 6.


Background: Multiple system atrophy with parkinsonism (MSA-P) is a progressive condition with no effective treatment.

Objective: The aim of this study was to describe the safety and efficacy of deep brain stimulation (DBS) of globus pallidus pars interna and externa in a cohort of patients with MSA-P.

Methods: Six patients were included. Changes in Movement Disorders Society Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III), Parkinson's Disease Questionnaire (PDQ-39) scores, and levodopa equivalent daily dose were compared before and after DBS. Electrode localization and volume tissue activation were calculated.

Results: DBS surgery did not result in any major adverse events or intraoperative complications. Overall, no differences in MDS-UPDRS III scores were demonstrated (55.2 ± 17.6 preoperatively compared with 67.3 ± 19.2 at 1 year after surgery), although transient improvement in mobility and dyskinesia was reported in some subjects.

Conclusions: Globus pallidus pars interna and externa DBS for patients with MSA-P did not result in major complications, although it did not provide significant clinical benefit as measured by MDS-UPDRS III. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Keywords: deep brain stimulation; globus pallidus; multiple system atrophy; neuromodulation.

MeSH terms

  • Deep Brain Stimulation* / adverse effects
  • Globus Pallidus / surgery
  • Humans
  • Multiple System Atrophy* / etiology
  • Multiple System Atrophy* / therapy
  • Parkinson Disease* / drug therapy
  • Subthalamic Nucleus* / surgery
  • Treatment Outcome