Deep Brain Stimulation Improves Parkinson's

Subthalamic nucleus deep brain stimulation (STN DBS) provides clinical improvement in patients with advanced Parkinson's disease (PD), without any increase in mortality or permanent new neurologic deficits, according to a new study.

From March 1999 to September 2003, 100 consecutive patients with advanced PD were implanted with a total of 191 subthalamic stimulator devices at New York Presbyterian Hospital/Columbia University Medical Center (New York, NY, USA). Sixteen patients had undergone prior surgery for PD (pallidotomy, thalamotomy, or fetal transplant). Microelectrode-guided implantations were performed one to two weeks before the pulse generator in patients.

The results showed that STN stimulation was associated with a 69% reduction in daily wearing-off episodes, a 60% reduction in dyskinesia severity, and a 30% decline in medication requirements. Three quarters of the patients experienced no morbidity, and overall the complication rate was 37% among the patients and 19% for the implants.
A subset of patients who underwent rigorous clinical evaluation showed a 29.5% reduction in motor scores after STN stimulation. The results were reported in the January 2006 issue of the Journal of Neurology, Neurosurgery, and Psychiatry.

Electrode implantation required an average hospital stay of 3.1 days and only four patients required stays exceeding six days. The most common challenge was battery failure, which occurred in 16 cases after an average 24.6 months. There were no complications associated with battery replacement.

Brain stimulation therapies for movement disorders and other chronic neurologic disorders is one of the largest 'growth' areas in clinical neuroscience, said lead author Dr. Robert R. Goodman, of the Neurological Institute of New York, Columbia College of Physicians and Surgeons (New York, NY, USA).



Related Links:
Neurological Institute of New York
N.Y. Presbyterian Hospital/Columbia U. Medical Center