Deep brain stimulation (DBS) surgery is the first procedure to show potential for slowing any major symptom of Parkinson’s disease, according to a Neurology study published online on June 29.
The surgery, often called a pacemaker for the brain, involves implanting a neurostimulator that sends electrical impulses to electrodes placed in areas of the brain that affect movement. The amount of stimulation is dictated by the neurologist and administered by the patient.
The procedure is recommended for patients with more advanced Parkinson’s disease when their medication is insufficient in managing symptoms. The operation has been shown to improve motor symptoms such as tremors and stiffness, also improving quality of life, while reducing the need for medication and its accompanying side effects.
To find out if DBS could slow tremor in the early stages of Parkinson’s disease, researchers at Vanderbilt University in Nashville, TN, recruited 28 patients with Parkinson’s disease, aged between 50 and 75, who had been on Parkinson’s medication for at least six months and not more than four years and had no history of dyskinesia (involuntary movements) or other movement problems. Participants were then randomly assigned to receive either optimal drug therapy (ODT) or DBS and ODT.
Forty-six percent of patients in the DBS plus ODT group developed a tremor in previously unaffected limbs over the course of the two-year study compared to 86 percent of patients in the ODT group. Four of the DBS patients saw improvements in their rest tremors and in one patient, the rest tremor disappeared completely.
The study suggests that DBS may be appropriate in earlier stages of the disease, the authors noted. "We must conduct a pivotal trial to ensure patient safety and provide the Parkinson's community with the best possible medical evidence to guide treatment," wrote senior author David Charles MD, FAAN, professor of neurology at Vanderbilt University Medical Center and chief medical officer of the Vanderbilt Neuroscience Institute. The findings are due to be tested in a US Food and Drug Administration-approved, phase 3, multicenter clinical trial evaluating DBS in early Parkinson’s disease.