- New
research indicates that deep brain stimulation is effective in the long
term for people with advanced Parkinson’s disease.
- Deep
brain stimulation has proven to be an effective therapy for Parkinson’s
disease, but its long-term efficacy compared to medications had been
previously unknown.
- There’s
no known cure for Parkinson’s, but research is ongoing.
New research out of
Germany shows that deep brain stimulation could have a positive impact on the
quality of life for people with advanced Parkinson’s disease.
Researchers from the
University of Cologne compared two groups of people with Parkinson’s disease:
one treated via deep brain stimulation of the subthalamic nucleus and one
treated with standard-of-care medication.
After a 5-year follow-up
period, researchers reported that the quality of life remained stable in the
group treated with deep brain stimulation while the quality of life declined in
the group that had received standard-of-care medication.
The findings were published today in
the medical journal JAMA.
Two experts interviewed
by Medical News Today say the research is further proof that
deep brain stimulation is an effective therapy for people who’ve been diagnosed
with Parkinson’s disease.
Parkinson’s
disease and the brain
Some symptoms of Parkinson’s disease manifest
in different parts of the body. However, motor symptoms originate in the brain,
when nerve cells in the midbrain die off.
“We know that the
disease affects dopaminergic neurons in the brain, so brain cells that make
dopamine are slowly degenerating,” explained Dr. David Charles, a
professor and vice chair of neurology and the medical director of Vanderbilt
Telehealth at Vanderbilt University Medical Center in Tennessee.
“As for the cause of
that degeneration, there are lots of theories out there, but the cause of
typical Parkinson’s disease remains a mystery,” said Charles, who was not
involved in the study.
Even though there’s no
conclusive understanding of the causes of Parkinson’s disease, its origins in
the brain mean that deep brain stimulation can be an effective treatment.
Deep brain stimulation
was first approved by the
U.S. Food and Drug Administration in 1997 and remains a widely used standard of
care therapy for people with Parkinson’s disease.
“Therapeutic
effectiveness has been well documented and in the United States every major
commercial insurance covers it. It’s a tried and true proven therapy that
benefits properly selected patients,” Charles told Medical News Today.
Important
findings for Parkinson’s disease research
Charles and his
colleagues have researched deep brain stimulation for people with early stage
Parkinson’s while the study out of Germany compared people with advanced stages
of the disease.
“My impression of this
report is excellent,” Charles said. “I think they nicely address the
limitations of the trial design that they used and so I think that their
findings are very helpful to the Parkinson’s community.”
Dr. Jean-Philippe Langevin,
a neurosurgeon and director of the Restorative Neurosurgery and Deep Brain
Stimulation Program for Pacific Neuroscience Institute at Providence Saint
John’s Health Center in California, agreed.
“This is an important,
rigorous, and important study,” Langevin, who was not involved in the study,
told Medical News Today.
Langevin added that
prior studies had proven the effectiveness of deep brain stimulation in
comparison to standard-of-care therapy, but a question remained: Would deep
brain stimulation maintain its superiority in the long term or would it
eventually show diminishing returns?
“This study looked at
the outcomes and patient quality of life five years after the surgery,”
Langevin explained. “The authors are reporting that quality of life is
maintained in the [deep brain stimulation] cohort, but that it worsens in the
medical therapy group. The difference in quality of life was linked to better
motor performance with [deep brain stimulation], so that patients can perform
their activities of daily living.”
Showing
support for people with Parkinson’s
Deep brain stimulation
may be an effective therapy for people living with Parkinson’s disease, but
this doesn’t change the fact that Parkinson’s is a devastating condition.
There’s no known cure
and symptoms get progressively worse with time.
A Parkinson’s diagnosis
often means that a person may not be able to take part in their usual hobbies
or activities, said Langevin. This impacts their independence and makes support
from family, friends, and loved ones especially important.
“The patient may need
help with basic activities of daily living such as bathing and getting
dressed,” said Langevin. “Parkinson’s disease is a life-transforming condition
that threatens the patient’s independent living capabilities and quality of
life.”
The underlying causes of
Parkinson’s disease are shrouded in mystery, but researchers are trying to gain
a more nuanced understanding.
“There are lots of
different lines of research ongoing and one line that’s super interesting is
trying to understand the genetic influences that may predispose someone to
Parkinson’s disease. Another area that’s kind of related is gene therapy that
could somehow address any finding in the genetics category,” said Charles.
“There’s also cell-based
therapy, where we explore whether we could implant cells in the brain that
would help people with Parkinson’s,” he added. “For a person with newly
diagnosed Parkinson’s, the news is good. We have therapies available for
Parkinson’s, and there’s multiple lines of robust research underway.”
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