Deep brain stimulation remains effective for Parkinson's disease after 15 years

Deep brain stimulation of the subthalamic nucleus remained effective 15 years after the surgical procedure in patients with Parkinson’s disease, according to results from a small study published in Neurology.

Specifically, the procedure resulted in a “significant improvement” in motor complications, as well as a stable decrease in the use of dopaminergic drugs, study results showed. The researchers also found that patients who received deep brain stimulation were able to maintain improvements in quality of life despite the natural progressive course of PD, including worsening of levodopa-resistant motor and non-motor symptoms.

“Deep brain stimulation benefits seem to last for several years but not enough data have been available to show that these effects are still present more than 15 years after surgery,” study author Elena Moro, MD, PhD, of the Grenoble Alpes University in France and a fellow of the American Academy of Neurology, said in a press release. “We wanted to know if people with Parkinson’s disease continue to benefit from this treatment. It is exciting to report that our study found [that] in the long run, deep brain stimulation continues to be effective in people with Parkinson’s disease.”

Moro and colleagues aimed to examine the impact of deep brain stimulation more than 15 years after the surgical procedure, with a primary focus on changes in motor complications among patients with PD. The researchers retrospectively evaluated all consecutive patients with PD who were operated on with bilateral deep brain stimulation at the Grenoble Alpes University Hospital between 1993 and 2004. They obtained data on motor complications, quality of life, activities of daily living, Unified Parkinson’s Disease Rating Scale motor scores, dopaminergic treatment, stimulation parameters and side effects of deep brain stimulation at 1 year and more than 15 years following the procedure.

The researchers identified 138 patients who underwent deep brain stimulation between 1993 and 2004. Long-term follow-up data were available for 51 of these patients, according to the study data. The mean long-term follow-up time was 17.06 years, with a median of 16 years (range, 15-24 years).

Compared with baseline, Bove and colleagues found that the time spent with dyskinesia and the time spent in an “off” state decreased by 75% (P < .001) and by 58.7% (P < .001), respectively. They observed a reduction in the use of dopaminergic drugs by 50.6% (P < .001), according to the study results.

The Parkinson’s Disease Quality of Life Questionnaire total score, as well as the emotional function and social function domains, improved by 13.8% (P = .005), 13.6% (P = .01) and 29.9% (P < .001), respectively, the researchers reported. Bove and colleagues also noted “few and mostly manageable” adverse events related to the device during the follow-up period.

“Our study also found that, despite the natural progression of Parkinson’s disease and the worsening of some symptoms that become resistant to medications over the years, participants still maintained an overall improvement in quality of life,” Moro said in the press release. “Future studies should continue to examine the benefits of deep brain stimulation over longer periods of time and in larger groups of people.”

Reference:

American Academy of Neurology. After 15 years, deep brain stimulation still effective in people with Parkinson’s. Available at: https://www.aan.com/PressRoom/Home/PressRelease/4900. Accessed June 3, 2021.