Saturday, September 06, 2008
Brain Stimulation Better Than Best Medical Therapy For Parkinson's
Preliminary data from ongoing trials suggest that deep brain stimulation (DBS) may be superior to the best medical therapy (BMT) for Parkinson's. In one trial of more than 300 patients, ages 22 and older, who were randomized to DBS vs BMT, the data showed that motor functioning at 6 months improved by 35% with deep brain stimulation as opposed to 5% with best medical therapy. However adverse effects were more common in the DBS group - 40% in comparison to 11% in BMT patients.
The best medical therapy arm of the trial was discontinued since there was enough data to evaluate the primary outcome. The deep brain stimulation patients were then randomized to 2 groups to compare bilateral stimulation of the subthalamic nucleus (STN) and globus pallidus interna (GPI) which comprise part of the basal ganglia - the part of the brain which is integral in the control of movement, motivation and addiction. Stimulation of these specific areas may cause different outcomes in mood, cognition, and movement. More specific targeting of these areas eventually may help decrease the adverse effects. The results of this part of the trial will not be available until 2009.