PARKINSON'S DISEASE NEWS

16th April 2011 - New research

THE CONSENSUS ON DBS FOR PARKINSON'S DISEASE

Archives of Neurology [2011] 68 (2) : 165 (Bronstein JM, Tagliati M, Alterman RL, Lozano AM, Volkmann J, Stefani A, Horak FB, Okun MS, Foote KD, Krack P, Pahwa R, Henderson JM, Hariz MI, Bakay RA, Rezai A, Marks WJ Jr, Moro E, Vitek JL, Weaver FM, Gross RE, DeLong MR.) Complete abstract

An international consortium of experts organized, reviewed the literature concerning DBS (Deep Brain Stimulation) for Parkinson's Disease in order to provide recommendations to patients, physicians, and other health care providers. Deep Brain Stimulation (DBS) involves the use of electrodes that are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS can reduce the need for L-dopa and related drugs, which in turn decreases the dyskinesias that are a common side effect of L-dopa. It also helps to alleviate fluctuations of symptoms and to reduce tremors, slowness of movements, and gait problems. For more information go to Deep brain stimulation.

The following recommendations were agreed on by all members : (1) Patients with Parkinson's Disease without significant active cognitive or psychiatric problems who have medically intractable motor fluctuations, intractable tremor, or intolerance of medication adverse effects are good candidates for DBS. (2) DBS surgery is best performed by an experienced neurosurgeon with expertise in stereotactic neurosurgery who is working as part of a inter-professional team. (3) Surgical complication rates are extremely variable, with infection being the most commonly reported complication of DBS. (4) DBS programming is best accomplished by a highly trained clinician and can take 3 to 6 months to obtain optimal results. (5) DBS improves L-dopa responsive symptoms, dyskinesia, and tremor. Benefits seem to be long-lasting in many motor domains. (6) Subthalamic nuclei DBS may be complicated by increased depression, apathy, impulsivity, worsened verbal fluency, and executive dysfunction in some patients. (7) Both globus pallidus pars interna and subthalamic nuclei DBS have been shown to be effective in addressing the motor symptoms of Parkinson's Disease. (8) Ablative therapy is still an effective alternative and should be considered in a select group of appropriate patients. For more current news go to Parkinson's Disease News.

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Parkinson's Disease News details all significant new research, news reports, new books, and new resources concerning Parkinson's Disease and those medical disorders that often coincide with Parkinson's Disease. It is compiled from an analysis of  all newly published research, news reports, new clinical trials, all newly published books, and new web sites. A summary and analysis of the new research are provided,  as well as links to the complete abstracts and news reports