Treatment Involving Deep Brain Stimulation For Patients With Advanced Parkinson Disease Provides Benefits--

Patients with advanced Parkinson disease (PD) who received deep brain stimulation treatment had more improvement in movement skills and quality of life after six months than patients who received other medical therapy, but also had a higher risk of a serious adverse events, according to a study in the January 7 issue of JAMA.

Deep brain stimulation is a surgical treatment involving the implantation of electrodes that send electrical stimulation to specific parts of the brain to reduce involuntary movements and tremors. It is the surgical intervention of choice when PD motor (movement) complications are inadequately managed with medications, according to background information in the article. "However, recent reports highlighting unexpected behavioral effects of stimulation suggest that deep brain stimulation, while improving motor function, may have other less desirable consequences," the authors write. They add that there are few randomized trials comparing treatments, and most studies exclude older patients.

Neurocognitive testing revealed decrements in some areas of information processing for patients receiving deep brain stimulation vs. best medical therapy.

The overall risk of experiencing a serious adverse event was 3.8 times higher in deep brain stimulation patients than in best medical therapy patients. Forty-nine deep brain stimulation patients (40 percent) experienced 82 serious adverse events. Fifteen best medical therapy patients (11 percent) experienced 19 serious adverse events. The most common serious adverse event was surgical site infection, with other serious adverse events including nervous system disorders, psychiatric disorders, device-related complications and cardiac disorders.

Comments

[David Gollup]

I had deep brain stimulation in June 2009. As of this posting, mid-October, 2009, I have had a number of adverse effects including seizures, depression, trouble speaking and cognitive impairment. My thought process and ability to verbalize thoughts has been severely impaired. I am thinking of filing a malpractice suit against the hospital and physicians that conducted the surgery, as non of these potential post surgical complications were discussed with me prior to the surgery. While my quality of life was comprised prior to the surgery, my quality of life has diminished even more post surgery.