Study: Brain stimulation boosts quality of life for Parkinson's patients


Published: Friday, January 9, 2009 at 6:01 a.m.
Last Modified: Thursday, January 8, 2009 at 7:42 p.m.

A new study reported in the Journal of the American Medical Association found that deep brain stimulation improved both physical function and quality of life in patients with Parkinson's disease.

In the national study, 255 people with advanced Parkinson's disease received either the deep brain stimulation surgery along with standard drug treatment or treatment with medication alone. Participants were treated at seven Veterans Affairs medical centers and six university hospitals.

Parkinson's disease affects more than one million Americans, who suffer from increasingly severe tremors. As the disease advances, these motor symptoms often are accompanied by anxiety and depression.

Dr. Michael Okun, a co-director of the Movement Disorders Center at the McKnight Brain Institute, said Wednesday that the study findings are consistent with those from a study sponsored by the National Institutes of Health that is currently under way at the University of Florida. UF did not take part in the study reported in JAMA.

"We've just completed a separate study looking at cognitive and mood changes after deep brain stimulation at two specific sites within the brain," Okun said.

In that study, to be published in an upcoming issue of the Annals of Neurology, there were no differences in motor function between the two different regions of the brain that were targeted.

Patients whose deep brain stimulation targeted one small group of nuclei have shown more potential cognitive benefit, while the potential for reducing the dosage of medication appeared better when the second area was targeted.

In deep brain stimulation, electrodes are implanted in a patient's brain and attached to a pacemaker-like device that sends tiny electrical impulses to the brain that disable overactive nerve cells.

It was approved for use in Parkinson's cases by the U.S. Food and Drug Administration in 2002. The Movement Disorders Center at UF does about 100 such surgeries each year for Parkinson's and other movement or neuropsychiatric disorders, according to Okun, who serves as medical director of the National Parkinson Foundation.

"It is important to use these results to tailor the right therapy for the right patients," he said. "We have many options, and must use the data to find the best option for the individual."

The results reported in the Jan. 7 issue of JAMA are from the first large study to include older patients. About 20 percent of those in the study were over the age of 70 and had good results, although younger candidates fared better.

"We at UF have never excluded anyone from DBS therapy strictly on the basis of age, provided they looked like a good candidate otherwise," Okun said.

"The key is to individualize the therapy for the specific patient."

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