• Randomized Trial of Deep-Brain Stimulation for Parkinson’s Disease

    • Feb 28, 2022

    • Parkinson’s Disease is a debilitating progressive neurologic disease that tends to lose response to medication over time.
    • Deep brain stimulation is a surgical alternative offered to medically refractory Parkinson’s patients with different targets considered depending on most bothersome symptom.
    • Multi-center, randomized-pairs trial.
    • Patients enrolled in this randomized trial were under 75 years old, had no dementia or major psychiatric problems, and had motor or dyskinesias from Parkinson’s disease that limited their ability to perform daily activities, and had failed maximal medical management.
    • Primary outcomes studied were PDQ-39 score and UPDRS-III score at six months, measuring quality of life and motor function, respectively
    • Secondary outcomes studied include dyskinesia scale, UPDRS-II (activities of daily living), and Schwab and England Scale (functional score).
    • 178 patients were randomly assigned to surgical or medical management.
    • Surgical group underwent bilateral DBS placement targeted at the subthalamic nucleus.
    • Outcomes: Surgical cohort demonstrated a greater improvement in quality of life and motor scores, and activities of daily living.
    • Limitations: No sham or placebo surgery was performed. Neurostimulation can alter response to Parkinson’s medications.
    • Conclusion: Bilateral neurostimulation of the subthalamic nucleus resulted in clinically meaningful improvement in quality of life, dyskinesias, and motor function in patients under 75 with advanced Parkinson’s Disease.

    Source

    Reference:

    NEJM

    https://www.nejm.org/doi/full/10.1056/nejmoa060281

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