Landmark study finds deep brain stimulation slows Parkinson’s progression
New data chronicling the long-term effects of deep brain stimulation (DBS) on early-stage Parkinson’s disease patients has found the treatment significantly slows its progression. Researchers from Vanderbilt University Medical Center suggest, if the results are validated in a large Phase 3 trial currently underway, DBS will become the first therapy clinically proven to slow the progression of this neurodegenerative disease.
For several decades deep brain stimulation has been used to effectively treat symptoms in severe Parkinson’s disease sufferers. The treatment involves several tiny wires being implanted into a patient’s brain which deliver sporadic electrical currents to specific parts of the brain.
Generally the treatment is reserved for patients with more severe symptoms, or those who have developed an intolerance to common medications. The invasive nature of brain surgery is not without risks, so DBS is not often considered for most early-stage Parkinson’s patients, particularly since before now it wasn’t believed to actively slow progression of the disease.
This new study reports the long-term results of a trial conducted more than a decade ago. Thirty early-stage Parkinson’s patients were enrolled between 2006 and 2009. Half the cohort received DBS surgery alongside standard drug therapies.
The newly published follow-up data reveals, five years later, those control patients receiving only the standard drug therapies were five times more likely to suffer worsening rest tremors compared to those in the DBS group. Those patients in the control group also needed, on average, significantly greater doses of medications to control their symptoms compared to the DBS group.
"Patients who were randomized to receive early optimal drug therapy had 15-fold greater odds of needing multiple types of Parkinson's disease medications," says Mallory Hacker, one of the authors on the new study.
David Charles, senior author on the new study, says although these results are “incredibly exciting”, physicians should not be changing clinical advice for new patients at this stage. A larger, multi-site, double-blinded randomized clinical trial is currently underway following 130 early-stage patients, and this study will hopefully offer clearer indications of how effectively DBS slows progression of the disease.
"Parkinson's is relentless,” says Charles. “There's nothing that slows down its progression. With this pilot study, we've shown that if DBS is implanted early it's likely to decrease the risk of progression, and if this is borne out in our larger study it would be a landmark achievement in the field of Parkinson's disease.”
The new research is published in the journal Neurology.