A new multi-center study, including neurologists and neurosurgeons from the Perelman School of Medicine at the University of Pennsylvania, reveals that Deep Brain Stimulation (DBS) – a treatment for Parkinson’s disease (PD) patients with medication-resistant muscle movement impairment or tremors – can improve those symptoms and reduce medications for patients implanted with the device. The study appears Online First in Lancet Neurology.
“The study answered some very important questions concerning cognition and mood with implantation alone, versus implantation with stimulation. We found that DBS surgery did not increase depressive symptoms, it actually led to an improvement in depression scores, and also led to improvements in motor ability and medication levels,” said Stacy Horn, DO, assistant professor of Clinical Neurology with Penn's Parkinson's Disease and Movement Disorders Center, who led the clinical trial at Penn Medicine and co-authored the paper.
Gordon H. Baltuch, MD, PhD, a professor of Neurosurgery in the Perelman School of Medicine at the University of Pennsylvania and study co-author, noted that “the group also dropped the infection rate to 4 percent from previously published 10 percent, which shows that, as a field, we are collectively improving the safety of this procedure and working in a collaborative fashion.”
Contrary to previous research, DBS devices implanted in the subthalamic nuclease (StN) did not appear to cause depression. In the study, depression scores improved significantly in the stimulation group at three months, compared to the control group of implanted patients who hadn't had their devices turned on yet (9.14 versus 1.8 points, using the Hamilton Depression Inventory (HDI) ). The study also shows that DBS using constant current can benefit PD patients, compared with constant voltage configurations.
The study was funded by the DBS device maker, St. Jude Medical Neuromodulation Division, and, as required by Lancet Neurology, the data was separately analyzed by an independent statistician at an academic institution.
Subthalamic deep brain stimulation with a constant-current device in Parkinson's disease: an open-label randomised controlled trial. The Lancet Neurology, Early Online Publication, 11 January 2012.