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Greater improvement in quality of life following unilateral deep brain stimulation surgery in the globus pallidus as compared to the subthalamic nucleus

Contact Information


Laura B. Zahodne,

Cognition, Deep brain stimulation, Depression, Parkinson disease , Quality of life


While deep brain stimulation (DBS) surgery is a well-accepted treatment for Parkinson disease (PD) that improves overall quality of life (QoL), its effects across different domains of QoL are unclear. The study reported here directly compared the effects of unilateral DBS in subthalamic nucleus (STN) or globus pallidus (GPi) on QoL in 42 non-demented patients with medication-refractory PD. Patients were enrolled in the COMPARE trial, a randomized clinical trial of cognitive and mood effects of STN versus GPi DBS conducted at the University of Florida Movement Disorders Center. Patients underwent motor, mood, verbal fluency and QoL (Parkinson disease questionnaire: PDQ-39) measures before and 6 months following surgery. Groups experienced motor and mood improvements that did not differ by target. Patients with STN DBS evidenced a slight decrement on letter fluency. On average, all patients endorsed better overall QoL after surgery. However, despite similar motor and mood improvements, GPi patients improved more than STN patients (38 vs. 14%, respectively; P = 0.03). Patients reported better QoL on subscales of mobility, activities of daily living (ADLs), emotional well-being, stigma, cognition and discomfort, but not on those of social support and communication. Improvements on the mobility, ADLs, stigma and social support subscales were greater amongst GPi patients. In regression analyses, only depression changes independently predicted changes in overall QoL as well as emotional well-being and social support changes. Within the STN group only, declining category fluency scores correlated with poorer QoL on the communication subscale. Unilateral DBS in both STN and GPi improved QoL overall and in disparate domains 6 months after surgery. Patients receiving GPi DBS reported greater improvements that cannot be explained by differential mood or motor effects; however, verbal fluency changes may have partially contributed to lesser QoL improvements amongst STN patients.


Okun, M. S., Rodriguez, R. L., Mikos, A., Miller, K., Kellison, I., Kirsch-Darrow, L., … Bowers, D. (2007). Deep Brain Stimulation and the Role of the Neuropsychologist. The Clinical Neuropsychologist, 21(1), 162–189.





Conent Area

Laura B. Zahodne

EWB-Related Construct

(4) quality of life

Study Design

Species or Study Population

(5) RCT

Sex (%Female)


Age (Mean, SD)

61.32, 7.37

Younger Controls?


Longitudinal Data?


Sample Size



unilateral deep brain stimulation surgery

Ethnicity (%white)

Not Stated (US)

Inclusion Criteria


Exclusion Criteria


EWB Measures

(1) Quality of life: Parkinson disease questionnaire (PDQ)

Non-EWB Behavioral

(1) Mood: Beck Depression Inventory
(2) Verbal Fluency: letter and semantic fluency

Physiological Measures


Brain IMaging Modality

Brain IMaging Paradigm


Brain Region/Circuit


Biological Measures


Other Neural Measures

Data Availability?


Data Avalability Details


Diagnostic Measures

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