Neurostimulation Benefits Early Parkinson's Disease According to Study

For those with early motor complications due to Parkison'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, researchers found that the neurostimulation group had significantly improved the quality of life for numerous patients 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. However, serious adverse events in 54.8 percent of patients in the neurostimulation group compared with 44.1 percent of the patients receiving medical therapy alone, and 17.7 percent of patients had serious adverse events associated with surgical implantation of 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. Conclusions show that subthalamic stimulation was superior to medical therapy in patients with Parkinson's disease and early motor complications, according to the study.