| Sumario: | Objective To compare the effect of different stimulation targets of deep brain stimulation (DBS) in Parkinson's disease (PD). Methods Eighty PD patients who underwent DBS at The First Affiliated Hospital of Shihezi University from January 2021 to December 2024 were included. Disease severity was assessed using the Hoehn-Yahr staging at 2 weeks preoperatively and 12 weeks postoperatively. Unified Parkinson's Disease Rating Scale III (UPDRSIII) was evaluated motor symptoms, Wechsler Memory Scale (WMS) was assessed explicit memory, Verbal Fluency Test (VFT) was evaluated language function, Clock Drawing Test (CDT) was assessed executive ability, Mini-Mental State Examination (MMSE) was evaluated overall cognitive function, Berg Balance Scale (BBS) was assessed balance function, Freezing of Gait Questionnaire (FOG -Q) was evaluated gait, and Chinese version of Parkinson's Disease Sleep Scale (PDSS) was assessed sleep quality. Levodopa equivalent dose (LED) and adverse reactions were also recorded. Results Patients were divided according to stimulation targets into subthalamic nucleus DBS (STN-DBS) group (n = 41) and globus pallidus interior DBS (GPi-DBS) group (n = 39). Postoperatively, the STN-DBS group showed significantly lower scores for motor symptoms [UPDRSIII (t = 10.325, P = 0.000), resting tremor (t = 8.696, P = 0.000), and rigidity (t = 9.850, P = 0.000)] compared with the GPi-DBS group. Both groups had significantly lower postoperative scores for motor symptoms [UPDRS III (t = 26.860, P = 0.000; t = 17.210, P = 0.000), resting tremor (t = 48.580, P = 0.000; t = 38.730, P = 0.000), rigidity (t = 26.110, P = 0.000; t = 21.570, P = 0.000), and bradykinesia (t = 21.360, P = 0.000; t = 18.320, P = 0.000)] than preoperatively. Postoperatively, the STN-DBS group had higher cognitive function scores [VFT (t = 7.269, P = 0.000), CDT (t = 4.466, P = 0.000)] than the GPi-DBS group, while both groups showed higher postoperative VFT (t = 12.902, P = 0.000; t = 6.548, P = 0.000) and CDT (t = 8.170, P = 0.000; t = 2.682, P = 0.000) scores compared with preoperatively. The STN-DBS group also exhibited higher scores on BBS (t = 5.896, P = 0.000), FOG-Q (t = 4.941, P = 0.000) and PDSS (t = 4.851, P = 0.000), and a lower LED (t = 13.810, P = 0.000) than the GPi-DBS group. Both groups had higher postoperative BBS (t = 14.070, P = 0.000; t = 6.570, P = 0.000) and PDSS (t = 17.400, P = 0.000; t = 10.080, P = 0.000) scores and lower FOG-Q scores (t = 18.230, P = 0.000; t = 25.860, P = 0.000) compared with preoperatively, while the STN-DBS group had a lower LED postoperatively than preoperatively (t = 19.910, P = 0.000). Conclusions STN-DBS and GPi-DBS are equally effective in the treatment of PD. Compared with GPi-DBS, STN-DBS has more advantages in improving motor symptoms, language function, executive ability, balance function, sleep quality, and reducing the dose of levodopa. In terms of gait freezing, GPi-DBS has more advantages than STN-DBS. Clinically, appropriate targets can be selected for treatment according to the symptoms of PD patients to achieve the expected effect.
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