Deep Brain Stimulation Helps Those With Advanced Parkinson's

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As Parkinson's advances, motor symptoms are often accompanied by anxiety, depression and other non-motor symptoms.

Generally, DBS, a procedure which involves placing a thin wire that can carry electrical currents deep within the brain, is performed after patients are already failing on their medications.

For this study, 255 Parkinson's patients were randomized to receive either DBS or "best medical therapy." One-quarter of the participants were 70 or older, a population underrepresented in previous trials.

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DBS was targeted either to the subthalamic nucleus (same as current practice) or to the globus pallidus; results of that comparison are forthcoming.

After six months, participants in the DBS arm gained about 4.6 hours per day of "on time," meaning time without troubling movement problems, compared with no gain for patients on best medical therapy.

Seventy-one percent of DBS patients, and only 32 percent of patients in the control group, experienced "clinically meaningful motor function improvements." Those receiving DBS also reported improvements in quality of life.

However, at least one serious adverse event occurred in 49 of the DBS patients vs. 15 in the other group.

Those receiving DBS also experienced small problems with cognitive functioning similar to patterns seen in previous studies and had more falls resulting in fractures and other injuries.

Although both younger and older patients gleaned similar benefits from DBS, older patients were more prone to adverse effects.

This "landmark" study, said Marks, "proved superior for such patients, rather than a tweak-and-adjustment [of medications] approach."

Hopefully, he added, the findings will encourage more neurologists to consider DBS for appropriate patients.

"I think this is going to spur those people who have still been on the fence about DBS to feel comfortable with it," Marshall said.

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