A recent article in Parkinson’s News Today reports that a reduction in a patient’s required medication and management of motor system disorders may be achievable with Deep-Brain Stimulation (DBS) for patients at various stages of the disease. DBS may improve the quality of life in Parkinson’s patients who are experiencing severe disease-related symptoms.
About Parkinson’s Disease
Parkinson’s disease, which usually affects people over age 50, is the direct result of the loss of dopamine-producing brain cells causing motor system disorders.
The most common symptoms are tremors, trembling and/or stiffness of limbs and trunk, slowness of movement and impaired balance and coordination. These symptoms eventually affect a person’s walking, speech and accomplishing simple tasks. Depression and emotional symptoms may occur as well as difficulty in swallowing and sleeping.
The disease is difficult to diagnose accurately as there are no blood or laboratory tests to identify sporadic Parkinson’s. Usually, the diagnosis is based on a person’s medical history and a neurological exam. Doctors may request brain scans or laboratory tests to rule out other diseases.
About Deep-Brain Stimulation (DBS)
DBS is a surgical procedure most commonly used to treat disabling neurological symptoms such as those associated with Parkinson’s disease.
DBS involves implanting a battery-operated device similar to a heart pacemaker called an implantable pulse generator(IPG). The IPG delivers electrical stimulation to the areas of the brain that control movement. This, in effect, blocks the abnormal nerve signals that cause Parkinson’s symptoms.
The procedure is minimally invasive, yet it does carry a risk that the stimulator may cause bleeding or infection in the brain. The IPG is designed so that the stimulator may be adjusted if the patient’s condition changes. The IPG can also be replaced in the event of unwanted side effects or if a newer, improved treatment is developed.
About the EARLYSTIM Study and Follow-up
The Subthalamic nucleus (STN), is one of the areas of the brain that is considered to play a key role in the origin of Parkinson’s disease. It is the main target for surgery when treating Parkinson’s.
The EARLYSTIM study was a Phase 4 clinical trial (NCT00354133) that evaluated the long-term effect of STN/DBS treatment along with “best medical treatment” for the quality of life patients. The study was conducted over a two year period.
A total of 251 patients, all under the age of 61, were enrolled in the study and divided into two groups. Patients in one arm of the study received treatment with DBS and best medical care. Patients in the second arm received best medical care only.
One of the primary endpoints was the Parkinson’s Disease Questionnaire (PDQ-39). The questionnaire was completed by the patients during the study. It provides insight into how the disease affects the patient’s functioning and the patient’s quality of life.
In a recent follow-up study, researchers reviewed the data from the EARLYSTIM trial and the PDQ-39. Their analysis revealed that quality of life was similar in the two groups.
Patients treated with STN-DBS who had poor quality of life according to PDQ-39 experienced improved quality of life changes. Patients with depression and mood disorders experienced quality of life improvement in the STN-DBS group. Details of the trial are available here.