Electrical stimulation of the brain -- a treatment in which a pacemaker-like device sends pulses to electrodes implanted in the brain -- is riskier than drug therapy but may hold significant benefits for those with Parkinson's disease who no longer respond well to medication alone.
That is the conclusion of researchers from the Department of Veterans Affairs (VA) and National Institutes of Health (NIH) who conducted a six-year study comparing deep-brain stimulation (DBS) to medication, along with speech, physical or occupational therapy, given as needed. The results of the trial, the largest of its kind to date, appear in the January 7 Journal of the American Medical Association (JAMA).
"Deep-brain stimulation offers hope for a large number of patients with advanced Parkinson's disease who suffer from complications of long-standing medication therapy," said Secretary of Veterans Affairs Dr. James B. Peake. "This finding could mean improved quality of life for some of our patients."
The study included 255 Parkinson's patients at seven VA medical centers and six university hospitals. The VA sites were Portland, Ore., Seattle, San Francisco, Los Angeles, Houston, Richmond, Va., and Philadelphia, all members of VA's network of Parkinson's Disease Research, Education and Clinical Centers.
The JAMA article also noted VA's nationwide system of hospitals and specialized centers of excellence make the Department uniquely capable of conducting such large, multi-site trials of new therapies and medical devices. VA's patient population is especially suited for trials of treatments for chronic disease in the elderly.
Patients who took part in the study were on medication but are no longer seeing improvements in symptoms such as tremors or stiffness. Many were also developing side effects from the drugs, such as involuntary face, arm or leg movements.
Researchers followed the patients for six months, finding: