Deep brain stimulation (DBS) is typically reserved for patients with advanced Parkinson's disease when medications no longer control their involuntary movements, usually after the disease has progressed for 10 or 15 years.
But researchers in France have demonstrated for the first time that the procedure appears to work just as well, if not better, in younger patients with milder symptoms. The procedure has enabled them to resume their careers and improve their overall quality of life, according to a new study in Neurology.
DBS requires surgery to implant tiny electrodes in the part of the brain that controls movement; they are then attached to a battery-powered device similar to a heart pacemaker that delivers regular electrical pulses. These pulses can relieve motor symptoms long after medications have failed. Younger patients seldom receive DBS because of concerns about surgical complications.
Michael Schüpbach, M.D., a movement disorders researcher at the Groupe Hospitalier Pitié-Salpêtrière in France, tested DBS in 20 patients within five years of their diagnosis. All had mild to moderate symptoms that had initially responded well to medication, but gradually worsened. After 18 months, their motor symptoms improved by 69 percent and medication doses were reduced by 57 percent. In contrast, symptoms in a comparison group of medication-only patients continued to worsen.
Until now, DBS has been used as a last resort in patients only after their symptoms become so advanced, even with medication, that there is no other option, says Dr. Schüpbach. Many of our patients were in their 50s and even 40s. The surgery improved their overall quality of life by 24 percent.