Wu Xin, Xue Tao, Pan Shiqing, Xing Weikang, Huang Chuanjun, Zhang Jianguo, Zhao Guozheng
Department of Neurosurgery, Suzhou Ninth People's Hospital, Suzhou, Jiangsu Province, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Heliyon. 2024 Mar 10;10(6):e27945. doi: 10.1016/j.heliyon.2024.e27945. eCollection 2024 Mar 30.
Globus pallidus internus (GPi) and subthalamic nucleus (STN) are two common deep brain stimulation (DBS) targets. This meta-analysis was to compared the efficacy and safety of these two DBS targets for the treatment of Meige syndrome (MS).
A systematic search was performed using EMBASE, MEDLINE, the Cochrane Library, and ClinicalTrials.gov to identify DBS trials for MS. Review Manager 5.3 was used to perform meta-analysis and the mean difference (MD) was analyzed and calculated with a random effect model. Pearson's correlation coefficients and meta-regression analyses were utilized to identify relevant predictive markers.
Twenty trials involving 188 participants with GPi-DBS and 110 individuals with STN-DBS were eligible. Both groups showed improvement of the Burke-Fahn-Marsden Dystonia Rating Scale-Movement (BFMDRS-M) and Disability (BFMDRS-D) scores (BFMDRS-M: MD = 10.57 [7.74-13.41] for GPi-DBS, and MD = 8.59 [4.08-13.11] for STN-DBS; BFMDRS-D: MD = 5.96 [3.15-8.77] for GPi-DBS, and MD = 4.71 [1.38-8.04] for STN-DBS; all < 0.001) from baseline to the final follow-up, while no notable disparity in improvement rates was observed between them. Stimulation-related complications occurrence was also similar between two groups (38.54 ± 24.07% vs. 43.17 ± 29.12%, P = 0.7594). Simultaneously, preoperative BFMDRS-M score and disease duration were positively connected with the relative changes in BFMDRS-M score at the final visit.
Both GPi-DBS and STN-DBS are effective MS therapies, with no differences in efficacy or the frequency of stimulation-related problems. Higher preoperative scores and longer disease duration probably predict greater improvement.
苍白球内侧部（GPi）和丘脑底核（STN）是两个常见的脑深部电刺激（DBS）靶点。本荟萃分析旨在比较这两个DBS靶点治疗梅杰综合征（MS）的疗效和安全性。
通过EMBASE、MEDLINE、Cochrane图书馆和ClinicalTrials.gov进行系统检索，以确定MS的DBS试验。使用Review Manager 5.3进行荟萃分析，并采用随机效应模型分析和计算平均差（MD）。利用Pearson相关系数和荟萃回归分析来确定相关的预测指标。
20项试验符合要求，其中188例接受GPi-DBS，110例接受STN-DBS。两组患者的伯克-法恩-马斯登肌张力障碍评定量表-运动（BFMDRS-M）和残疾（BFMDRS-D）评分均有改善（GPi-DBS组BFMDRS-M：MD = 10.57 [7.74 - 13.41]，STN-DBS组MD = 8.59 [4.08 - 13.11]；GPi-DBS组BFMDRS-D：MD = 5.96 [3.15 - 8.77]，STN-DBS组MD = 4.71 [1.38 - 8.04]；均P < 0.001），从基线到最终随访，两组改善率无显著差异。两组刺激相关并发症的发生率也相似（38.54 ± 24.07% 对 43.17 ± 29.12%，P = 0.7594）。同时，术前BFMDRS-M评分和病程与末次随访时BFMDRS-M评分的相对变化呈正相关。
GPi-DBS和STN-DBS都是治疗MS的有效方法，在疗效或刺激相关问题的发生率方面没有差异。术前评分较高和病程较长可能预示着改善程度更大。
