A group of researchers in Germany and France recently published the results of a clinical trial examining the benefits of Deep Brain Stimulation (DBS) in young patients in the early stages of Parkinson’s disease.
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Study Organization: Young Individuals with Recently Appeared Symptoms
The individuals considered had experienced motor complications for a short time, less than three years.
The subjects had not undergone standard pharmacological therapies but instead chose to undergo DBS early in their illness. The study followed them for two years and reported significant improvements among the DBS group compared to a control group receiving only pharmacological therapy.
Canadian Interest in European Deep Brain Stimulation Study
The study drew the attention of several Canadian doctors with extensive experience treating Parkinson’s, including Dr. Tony Lang, whose work with movement disorders and deep brain stimulation is highly regarded in the medical field.
Dr. Lang collaborates with the Movement Disorders clinic at Toronto Western Hospital and the University Health Network, Department of Neurology, University of Toronto, in Toronto, Canada.
Canadian researchers examined the results of the European trial from various perspectives beyond the actual clinical improvement of patients.
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CANADIAN RESEARCHERS’ CONSIDERATIONS REGARDING THE STUDY
Canadian researchers acknowledged that the intervention results in younger subjects, leading to a better quality of life for the patient and reduced tremors and stiffness. However, the European study also confirmed that DBS can have serious side effects, including the risk of suicide, which has also been demonstrated in other clinical studies.
Additionally, the Canadian group believes that offering DBS to patients with motor symptoms for less than 5 years may include people with atypical parkinsonism who would not benefit from the intervention.
CONSIDERING THE SEVERITY OF SYMPTOMS IN RELATION TO THE BENEFITS AND CONTRAINDICATIONS OF THE INTERVENTION
If the symptoms are mild, the intervention results will also be mild. Still, the contraindications of the intervention, such as infections, rejection of implanted materials, or response to neurostimulation, are the same for patients with more severe symptoms who would nevertheless see more significant benefits. Since the symptoms of Parkinson’s disease and their severity vary from individual to individual, the decision regarding this treatment must take into account the severity of the potential risks of DBS (Deep Brain Stimulation) and whether there is a team of experienced professionals capable of following the patient in case problems arise.
Deep Brain Stimulation Effective Only on Some Parkinson’s Symptoms
DBS is not effective for all Parkinson’s symptoms; for example, it does not benefit bradykinesia or freezing of gait, symptoms treatable with Gondola AMPS therapy. Additionally, issues like walking difficulties and freezing of gait could also be worsened or induced by installing the DBS device.
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ALSO, CONSIDER PLACEBO AND NOCEBO EFFECTS
The Canadian team emphasized that the European study was an open-label study, meaning that all participants received DBS, and no control group received placebo interventions.
Other Parkinson’s studies that included surgical procedures for cell transplantation have shown an extremely high and positive placebo response; the expectation of potential benefit can be very powerful.
Since all participants in the European study voluntarily underwent a series of invasive neurological procedures on their brains, it must be assumed that they had a high expectation of success. This may have created an overly positive response to the intervention.
Similarly, subjects who received only pharmacological therapy may have been negatively influenced by the nocebo effect, thinking they would not experience the same improvement as subjects with Deep Brain Stimulation; the benefits shown may have been lesser.
This is supported by the fact that after the first blinded part of the trial, most subjects in the traditional pharmacological therapy group chose to undergo DBS. Caution must be exercised in interpreting the results in light of these considerations.
Further Studies to Evaluate the Obtained Results
The results of the European study show some positive responses that are worth reevaluating with further, better-designed clinical trials. This study was conducted on a younger population with motor symptoms that had recently emerged and were good candidates for surgery.
Furthermore, they were followed for a relatively short period, two years. The results may not necessarily be valid for older subjects with other motor complications that may make them poor candidates for the intervention.
It’s not a matter of effectiveness, but when is the best time to apply it?
Deep Brain Stimulation can and has helped many people with Parkinson’s disease; its effectiveness is not questioned.
But what is questioned is when the best time is to apply DBS to achieve better results for the individual undergoing the intervention.
But what is questioned is when the best time is to apply DBS to achieve better results for the individual undergoing the intervention.
Many <Parkinson’s disease symptoms can be controlled long-term with pharmacological therapies and with the aid of the a href=”/gondola-home-device/” target=”_blank” rel=”noopener”>GONDOLA device, without the risks associated with a serious and invasive brain surgery.
The decision to undergo this intervention must be carefully considered by each individual, considering both potential benefits and potential contraindications.
An expert multidisciplinary team specializing in Parkinson’s disease and Deep Brain Stimulation should be able to advise the individual and be there to assist them during their decision and post-intervention.
