TUESDAY, Jan. 6, 2009 (Health.com) — People with Parkinson’s disease who have a pacemaker-like device implanted in the brain spend an extra four-plus hours a day free of tremors and involuntary movements than they do on medication, according to the largest study of the treatment, which is known as deep brain stimulation.
However, deep brain stimulation also has a correspondingly greater risk of problems, such as infection, due to the complicated surgery, according to the study published Tuesday in the Journal of the American Medical Association.
“It definitely is brain surgery and that should give anyone pause,” says David Charles, MD, of Vanderbilt University, in Nashville, who was not involved in the new study. Nevertheless, he adds, most of the problems seen in the study were related to the surgery itself, and many had resolved themselves within six months.
The findings are “encouraging,” he says, given that previous research has suggested that patients might develop much more serious problems, such as major depression and suicidal thoughts, than were seen in the current study.
In deep brain stimulation, electrodes are used to deliver electrical impulses to the substantia nigra, a crescent-shaped region in the center of the brain that controls and coordinates movement. In patients with Parkinson’s disease, dopamine-producing nerve cells in this region degenerate, causing tremors, stiffness, slowed movement, and loss of coordination.
Drugs like levodopa can help reduce tremors and involuntary movements. But for many people, this medication loses its effectiveness over time, while the side effects—such as sudden jerky movements, chewing motions, and hand tremors—get worse.
Introduced in the late 1990s, deep brain stimulation is becoming more widely accepted to treat such patients. But most studies have not been conducted in a way to clearly demonstrate the risks and benefits compared to medication alone.
Next: What the study found
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