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Longer follow-up is useful when comparing deep brain stimulation targets because early improvements may evolve over time. In this multicentre randomized controlled trial, patients with Parkinson disease were assigned to globus pallidus internus or subthalamic nucleus stimulation and followed for 36 months. Motor function improved significantly with both approaches, and the degree of improvement was similar between targets. Quality of life improved early but the magnitude of improvement diminished over time. Neurocognitive outcomes provided an additional distinction: the Mattis Dementia Rating Scale declined faster in the STN group, while other cognitive measures showed more gradual change in both groups. The findings reinforce that DBS target selection should not be reduced to a single motor score. For HCPs, a complete preoperative assessment of cognition, mood, medication burden, dyskinesia, gait and patient priorities can help identify the most appropriate target. The trial also highlights the importance of long-term follow-up because the benefit-risk profile of different targets is not captured by the first postoperative year alone. This evidence is directly relevant to IANCON's movement-disorder and DBS discussions.
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Longer follow-up is useful when comparing deep brain stimulation targets because early improvements may evolve over time. In this multicentre randomized controlled trial, patients with Parkinson disease were assigned to globus pallidus internus or subthalamic nucleus stimulation and followed for 36 months. Motor function improved significantly with both approaches, and the degree of improvement was similar between targets. Quality of life improved early but the magnitude of improvement diminished over time. Neurocognitive outcomes provided an additional distinction: the Mattis Dementia Rating Scale declined faster in the STN group, while other cognitive measures showed more gradual change in both groups. The findings reinforce that DBS target selection should not be reduced to a single motor score. For HCPs, a complete preoperative assessment of cognition, mood, medication burden, dyskinesia, gait and patient priorities can help identify the most appropriate target. The trial also highlights the importance of long-term follow-up because the benefit-risk profile of different targets is not captured by the first postoperative year alone. This evidence is directly relevant to IANCON's movement-disorder and DBS discussions.
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