Surgery for Parkinson’s

Good news for many Parkinson’s patients who are wondering whether to have brain surgery or not. A study from Germany has shown that deep-brain stimulation is more effective in relieving symptoms than medical management alone. Published in the New England Journal of Medicine, the report describes the results in 156 patients under 75 with advanced Parkinson’s disease who were randomized to receive neurostimulation of the subthalamic nucleus of the brain along with medication, or continue with medication alone.

Two recognized rating scale were used to assess changes in the disease over time. After 6 months, there were significant improvements in those having neurostimulation, compared with medication alone. The improvements represented 24% to 38% on the scales.

Serious adverse effects were more common with neurostimulation than with medication alone – 13% vs. 4% - and included a fatal hemorrhage. However, overall adverse effects were more common in the medication alone group – 64% vs. 50%.

Hopefully this relatively clear-cut result will help patients in taking their decision about whether to have the surgery or not. An important factor, of course, is to find a neurosurgeon familiar with the techniques involved; very familiar, actually. This is not nearly as easy as it sounds. There seems to be a shortage of neurosurgeons in the USA at present.