Study touts brain stimulation for Parkinson's
The treatment gave sufferers of the disease increased movement and a better quality of life than patients who received medication, researchers say.
Reporting from Chicago — Patients with advanced Parkinson's disease who received deep brain stimulation showed greater improvement in movement and quality of life after six months than those treated with medication, a new study shows.
But the deep brain stimulation patients had an almost four times greater risk of serious side effects such as depression, infections, falls or heart problems. Although most side effects could be treated, one patient suffered a brain hemorrhage and died.
With deep brain stimulation, doctors surgically implant electrodes that send electrical stimulation to specific parts of the brain to reduce involuntary movements and tremors. It is a widely accepted treatment for advanced Parkinson's disease, but few randomized trials have been conducted comparing treatments.
Previous studies have largely excluded older patients, who account for the majority of those with the disease. About 25% of the more than 250 patients in the new study were 70 or older.
In the study, which appears in this week's Journal of the American Medical Assn., patients were randomly selected to receive either medication or bilateral deep brain stimulation, with the electrodes implanted into the subthalamic nucleus or the globus pallidus areas of the brain.
Lead study author Frances Weaver said researchers were surprised by the magnitude of the differences in outcomes.
"The amount of time that patients were able to move normally increased by 4.6 hours," said Weaver, director of the Center for Management of Complex Chronic Care in Hines, Ill. "Our best medical therapy patient, on average, showed no improvement."
Researchers studied how long patients had good motor control, referred to as "on" time, without experiencing dyskinesia -- the jerky, uncontrolled movements patients develop after long-term use of medications to treat Parkinson's disease.
The research is the first to show that deep brain stimulation works as well in older patients as it does in younger ones, said Dr. Leo Verhagen, a neurologist and medical director of the movement disorders surgery program at Rush University Medical Center in Chicago.
"It's a major step forward," said Verhagen, who was not involved with the study.
Weaver was optimistic about the findings, but said deep brain stimulation was not a panacea.
