Clinical and Imaging Correlates of Medication Reduction in Globus Pallidus Stimulation for Parkinson's Disease

Mov Disord Clin Pract. 2025 Jul;12(7):985-990. doi: 10.1002/mdc3.70042. Epub 2025 Mar 18.

Abstract

Background: The magnitude and factors associated with levodopa equivalent daily dose (LEDD) reduction in deep brain stimulation (DBS) of the globus pallidus interna (GPi) for Parkinson's Disease (PD) remain unclear.

Objective: To investigate LEDD reduction in GPi DBS and its correlation with anatomical/clinical characteristics.

Methods: A consecutive cohort of 74 patients who had undergone GPi DBS was analyzed. Regression and probabilistic efficacy mapping were performed to evaluate factors predicting LEDD reduction.

Results: 32.4% of GPi individuals experienced significant LEDD reduction (>30%). Anteromedial GPi stimulation was associated with higher LEDD reduction.

Conclusion: Anteromedial stimulation of the GPi appears to be associated with medication reduction, challenging the idea that GPi DBS is ineffective at reducing LEDD. Further prospective study will be needed to validate these findings.

Keywords: Parkinson's disease; deep brain stimulation; globus pallidus; medication reduction; neuromodulation.

MeSH terms

  • Aged
  • Antiparkinson Agents* / administration & dosage
  • Antiparkinson Agents* / therapeutic use
  • Cohort Studies
  • Deep Brain Stimulation* / methods
  • Female
  • Globus Pallidus* / physiology
  • Humans
  • Levodopa* / administration & dosage
  • Levodopa* / therapeutic use
  • Male
  • Middle Aged
  • Parkinson Disease* / diagnostic imaging
  • Parkinson Disease* / drug therapy
  • Parkinson Disease* / therapy
  • Treatment Outcome

Substances

  • Levodopa
  • Antiparkinson Agents