Keywords
Deep brain stimulation
Subthalamic nucleus
Internal globus pallidus
UPDRS-III
Motor symptoms
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Abstract
Objective: To comparatively analyze the effects of deep brain stimulation (DBS) in the subthalamic nuclei (STN) and globus pallidus internus (GPi) on the motor performance of patients with Parkinson's disease, with emphasis on UPDRS-III scores under different pharmacological and stimulation conditions. Methods: Systematic review based on clinical trials identified in the PubMed, LILACS and SciELO databases. Studies that directly compared the effects of DBS in the STN and GPi were included, with quantitative evaluation of UPDRS-III motor scores under ON/OFF medication and stimulation conditions. Results: DBS in the STN demonstrated superiority in reducing the antiparkinsonian drug load, with an average reduction of up to 50% in the equivalent dose of levodopa. On the other hand, DBS in the GPi promoted greater stability in motor scores during the OFF medication state and presented a lower incidence of neuropsychiatric adverse effects, such as depression and cognitive decline. Final considerations: Both targets offer relevant clinical benefits in the motor management of Parkinson's disease, with distinct profiles. NST is preferable in cases requiring pharmacological reduction, while GPi is more indicated in patients with neuropsychiatric vulnerability. Target selection should be individualized, based on multidimensional assessment.
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