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Surgery for Parkinson’s disease: lack of reliable clinical trial evidence
  1. R L Stowe1,
  2. K Wheatley1,
  3. C E Clarke2,
  4. N J Ives1,
  5. R K Hills1,
  6. A C Williams3,
  7. J P Daniels1,
  8. R Gray1
  1. 1Birmingham Clinical Trials Unit, University of Birmingham, Birminham, UK
  2. 2City Hospital NHS Trust, Birmingham, UK
  3. 3Queen Elizabeth Hospital, Birmingham, UK
  1. Correspondence to:
 Dr R L Stowe, University of Birmingham Clinical Trials Unit, Park Grange, 1 Somerset Road, Edgbaston, Birmingham B15 2RR, UK; 
 r.l.stowe.1{at}bham.ac.uk

Abstract

There has been a striking resurgence of interest in surgery for Parkinson’s disease (PD) with new targets identified and new procedures developed. This systematic review identified over 500 studies of surgery for PD published since 1990, including over 10 000 patients. However, the authors were unable to assess the value of PD surgery reliably because only seven randomised trials were identified including just 196 patients. Studies of surgery for PD have generally been of poor quality with too few patients, too short follow up, inappropriate choice of outcome measures, and lack of control groups. Much larger, randomised, controlled trials are needed to assess the longer term effects of surgery on patient rated quality of life and cost effectiveness.

  • clinical trial
  • Parkinson’s disease
  • PD, Parkinson’s disease
  • GP, globus pallidus
  • STN, subthalmamic nucleus
  • DBS, deep brain stimulation
  • RCT, randomised controlled trial
  • UPDRS, Unified Parkinson’s Disease Rating Scale

https://doi.org/10.1136/jnnp.74.4.519

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    Footnotes

    • Funding: this review arose from background research for the PD SURG trial, which is funded by the Medical Research Council and the UK Parkinson’s Disease Society. This study is coordinated by the University of Birmingham Clinical Trials Unit, which receives core funding from the NHS Executive R&D. The views expressed in this article are, however, not necessarily those of the funding bodies.

    • Competing interests: none declared.