Neurostimulation Benefits Early Parkinson's Disease
(HealthDay News) – For patients with early motor complications due to Parkinson's disease, neurostimulation is associated with improved quality of life and motor ability, according to a study published in the Feb. 14 issue of the New England Journal of Medicine.
Noting that subthalamic stimulation can benefit patients with advanced Parkinson's disease and levodopa-induced motor complications, W.M. Michael Schuepbach, MD, from the Centre Hospitalier Universitaire Pitié-Salpêtrière in Paris, and colleagues randomly assigned 251 patients with Parkinson's disease and early motor complications to receive neurostimulation plus medical therapy or medical therapy alone.
After two years, the researchers found that the neurostimulation group had significantly improved quality of life, as assessed by the Parkinson's Disease Questionnaire-39 summary index (mean improvement of 7.8 points vs. mean worsening of 0.2 points for medical therapy alone). Neurostimulation also correlated with significant improvements in motor disability, activities of daily living, levodopa-induced motor complications, and time with good mobility without dyskinesia. There were serious adverse events in 54.8% of patients in the neurostimulation group compared with 44.1% of patients receiving medical therapy alone, and 17.7% of patients had serious adverse events associated with surgical implantation or the neurostimulation device.
"In conclusion, we found that neurostimulation was superior to medical therapy alone at a relatively early stage of Parkinson's disease, before the appearance of severe disabling motor complications," Schuepbach and colleagues write. "Neurostimulation may be a therapeutic option for patients at an earlier stage than current recommendations suggest."
Several authors disclosed financial ties to pharmaceutical and medical device companies.