Deep brain stimulation for Parkinson's disease and other movement disorders: an evidence-based analysis
Ministry of Health and Long-Term Care. Medical Advisory Secretariat
Record ID 32005000246
English
Authors' objectives:
This study aims to determine the effectiveness and adverse effects of deep brain stimulation (DBS) in the treatment of symptoms of idiopathic Parkinson's disease (PD), essential tremor, and primary dystonia, and to conduct an economic analysis if evidence for effectiveness is established.
Authors' results and conclusions:
There is level 1b evidence that bilateral DBS of the subthalamic nucleus is effective in the short-term control of advanced parkinsonian symptoms, and there is level 3a evidence that the effect is sustained for at least 5 years. There is Level 3a evidence that DBS of the thalamus is effective in the control of tremor in patients with essential tremor and PD for at least 6 years. There is level 3a evidence that bilateral DBS of the globus pallidus is effective in the control of symptoms of primary dystonia for at least 1 year.
Authors' recommendations:
According to the estimates of prevalence and evidence of effectiveness, there is a shortfall in the number of DBS procedures currently done in Ontario for drug-resistant PD, essential tremor, and primary dystonia.
Since complication rates are lower if DBS is performed in specialized centres, the number of sites should be limited.
The cost per procedure to institutions with the expertise to undertake DBS and the human resource considerations are likely to be limiting factors in the further diffusion of DBS.
Authors' methods:
Systematic review
Details
Project Status:
Completed
Year Published:
2005
URL for published report:
http://www.health.gov.on.ca/english/providers/program/mas/tech/reviews/pdf/rev_dbs_030105.pdf
URL for additional information:
http://www.hqontario.ca/en/mas/mas_ohtas_tech_dbs_030105.html
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Deep Brain Stimulation
- Electric Stimulation Therapy
- Movement Disorders
- Parkinson Disease
- Tremor
Contact
Organisation Name:
Medical Advisory Secretariat
Contact Address:
Medical Advisory Secretariat, 20 Dundas Street West, 10th Floor, Toronto, ON M5G 2N6 CANADA. Tel: 416-314-1092l; Fax: 416-325-2364;
Contact Name:
MASinfo.moh@ontario.ca
Contact Email:
MASinfo.moh@ontario.ca
Copyright:
Medical Advisory Secretariat, Ontario Ministry of Health and Long-Term Care
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.