Deep brain therapy effective in early Parkinson’s
U. QUEENSLAND (AUS) — Researchers report significant improvements in quality of life for patients who receive deep brain stimulation (DBS) therapy in the early stages of Parkinson’s disease.
“Before the release of this study, a typical patient with Parkinson’s disease would need to wait around 10 years or until their motor complications could no longer be treated successfully with medicine alone, before DBS surgery was considered an option,” says neurologist Peter Silburn, lead clinical professor from the Asia-Pacific Centre for Neuromodulation, a joint initiative of the University of Queensland and St Andrew’s Hospital.
Silburn says the findings, published in the New England Journal of Medicine, would transform the way physicians treat Parkinson’s disease.
“The study has confirmed the best medical practice for a person with Parkinson’s disease is to perform DBS surgery around 4 to 7 years into the condition, as opposed to waiting until the medications stop working.”
Participants in the EARLYSTIM trial had been experiencing symptoms of Parkinson’s disease for an average of 7.5 years—about five years less than participants in earlier trials—allowing researchers to test the benefits of DBS therapy when motor fluctuations and dyskinesia are of recent onset and occupational and psychosocial competence is still maintained.
Key findings from these participants two years after receiving DBS therapy include:
- 26 percent improvement in their disease-related quality of life
- 53 percent improvement in motor skills
- 30 percent improvement in activities of daily life (speech, handwriting, dressing and walking)
- 61 percent improvement in levodopa-induced complications (including dyskinesias and motor fluctuations)
- 39 percent reduction in daily levodopa equivalent dosage.
Participants who did not undergo DBS surgery and received the best medical therapy only, experienced no improvement in their quality of life, no change in their motor skills, a 12 percent decline in their ability to perform daily activities, a 13 percent worsening in their levodopa-induced complications, and a 21 percent increase in their daily levodopa equivalent dosage at two years.
Silburn hopes this study will serve as a paradigm shift in the way patients with Parkinson’s disease think about their treatment options, dispelling assumptions about the surgery.
“My message to people diagnosed with Parkinson’s disease is this: It doesn’t matter what age you are, or how far along you are in the disease, you don’t have to persist with the drugs, or wait until you’re so bad that nothing else helps, before considering DBS surgery,” Silburn says.
Source: University of Queensland
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