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Deep Brain Stimulation for Parkinson’s Disease: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Published on: December 14, 2018
Project Number: RC1049-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the comparative clinical effectiveness of deep brain stimulation versus standard care for treatment of Parkinson’s disease?
  2. What is the cost-effectiveness of deep brain stimulation versus standard care for treatment of Parkinson’s disease?
  3. What are evidence-based guidelines informing the use of deep brain stimulation for treatment of Parkinson’s disease?

Key Message

The clinical evidence on the effectiveness of deep brain stimulation for Parkinson’s disease compared to standard of care (i.e., best medical therapy) was mixed. Several unique outcomes were used to quantify clinical effectiveness, making it challenging to compile the clinical evidence. Furthermore, the methodological quality of the evidence was moderate resulting in some uncertainty in the findings. Evidence from three systematic reviews and five clinical studies (one randomized controlled trial and four secondary analyses of randomized controlled trials suggests deep brain stimulation may be clinically effective at managing Parkinson’s disease symptoms compared to standard of care; more research is warranted for definitive conclusions.Four economic evaluations were identified that addressed the cost-effectiveness research question. Results suggest deep brain stimulation may be cost-effective treatment option compared to standard of care. The methodological quality of the evidence was moderate which should be considered when interpreting these results. One evidence-based guideline satisfied the inclusion criteria for this report. This guideline recommends deep brain stimulation for people with advanced Parkinson’s disease whose symptoms are not adequately controlled by best medical therapy.

Tags

neurostimulator; DBS; neurostimulation; electrical stimulation; Electric Stimulation; Parkinson's; Parkinsons