Deep Brain Stimulation Beneficial in Parkinson's
Combined with best medical therapy, improves quality of life more than medical therapy alone
THURSDAY, May 6 (HealthDay News) -- Patients with advanced Parkinson's disease who undergo deep brain stimulation (DBS) in addition to the best medical therapy report better quality of life than patients who receive only best medical therapy, though they are at increased risk of serious adverse events, according to a study published online April 29 in The Lancet Neurology.
Adrian Williams, M.D., of Queen Elizabeth Hospital in Birmingham, U.K., and colleagues randomized 366 Parkinson's disease patients to receive surgery and best medical therapy (which involved standard Parkinson's disease drug treatments, including apomorphine when appropriate) or best medical therapy only. One year after treatment, the patients assessed changes to their quality of life on the Parkinson's disease questionnaire (PDQ), and functioning and cognitive status on the unified Parkinson's disease rating scale.
The researchers found that DBS surgery plus medical treatment improved quality of life more than medical treatment alone on the one to 100 PDQ scale (a 5.0 point improvement for surgery compared to a 0.3 point improvement for medical treatment only). Also, patients in the surgery group had significant improvements in mobility, daily living activities, and bodily discomfort, as well as reduced dyskinesia and duration of uncontrolled motor symptoms. However, 19 percent of surgery patients had serious surgery-related adverse events, one of whom died, and 20 patients in the surgery group had serious adverse events related to the disease and drug treatment, compared to 13 patients in the medical treatment group.
"At one year, surgery and best medical therapy improved patient self-reported quality of life more than best medical therapy alone in patients with advanced Parkinson's disease. These differences are clinically meaningful, but surgery is not without risk and targeting of patients most likely to benefit might be warranted," the authors write.
Two study authors reported receiving travel grants or professional fees from Medtronic.