Deep brain stimulation for Parkinson’s disease may help in the long term

Thursday, June 3, 2021 (HealthDay News) – Parkinson’s disease A new study shows that patients can relieve symptoms with long-term deep brain stimulation (DBS) treatment.

The researchers found that over a 15-year period, patients who underwent DBS, which requires surgical implantation, had significantly improved motor symptoms and less need for medication.

“Our study, for the first time, supports the efficacy of deep brain stimulation over the very long term – 15 years after surgery and 25 years since the diagnosis of Parkinson’s disease,” said senior researcher Dr. Elena Moreau, director of the Movement Disorders Unit. Grenoble Alpes University in France.

“In fact, after an average of 15 years after surgery, patients can feel better compared to before surgery,” she said. “Furthermore, we could still observe a significant decrease in anti-Parkinsonian medication and an improvement in quality of life, compared to what it was before the intervention.”

Patients with Parkinson’s disease no longer make dopamineWhich affects their speech, gait and balance. Symptoms can be partially relieved by the drug levodopa, which temporarily restores dopamine.

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But as dopamine levels fluctuate during the day, patients can experience dyskinesia, a side effect of levodopa that can cause the head to twist, sway, or bob.

Deep brain stimulation uses electrodes placed in areas of the brain to control symptoms of Parkinson’s disease. The electrodes are connected to a pacemaker-like device placed under the skin in the upper chest that transmits an electrical pulse that helps control symptoms. Many patients use a portable console to adjust stimulation levels as needed.

For the study, Morrow’s team collected data on 51 patients being treated with DBS. On average, they have had the device for 17 years.

Compared with the data before transplantation after 15 years, the number of times patients experienced dyskinesia was reduced by 75%. Use of medications to control dopamine levels decreased by 51%, and the amount of time the drug was no longer working as well decreased by 59%.

The researchers found few side effects from using the device for 15 years, and they were mostly manageable.

DBS is recommended in advanced Parkinson’s cases, and Morrow said surgery should not be delayed when motor conditions and quality of life have deteriorated despite other treatments.

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“This information is important for clinicians, patients, and their families when they need to make a decision about the surgical option for managing Parkinson’s disease,” she said. People with Parkinson’s disease should know that the beneficial effects of deep brain stimulation surgery will last for more than 15 years.

Dr. Michael Okun, National Medical Adviser to the Parkinson’s Foundation, said that DBS, when used with medications, has long-term effects in some patients. It was not part of the study.

“These long-term studies tell us a number of things,” said Okun, president and professor of neuroscience at the University of Florida. “The most important thing they tell us is that the disease continues to progress despite the intervention.”

Neither deep brain stimulation nor medication is a cure for the disease itself. “Where to get the long-term benefits are things like dyskinesia and motor fluctuations,” Okun said.

He said patients who do well on levodopa are the most likely to benefit from DBS.

Patients who still benefit from the device after 15 years are those whose disease progresses slowly. Okun said that people who develop Parkinson’s disease more quickly are not evaluated after 15 years.