According to a study published recently in the Parkinsonism and Related Disorders journal — “Long-term follow-up of subthalamic nucleus deep brain stimulation in patients with Parkinson’s disease: An analysis of survival and disability milestones” of R.Barbosa et al.—, Deep Brain Stimulation (DBS) of the subthalamic nucleus (STN) has emerged as a pivotal treatment for advanced Parkinson’s Disease (PD). This article investigates the long-term effects and survival rates post-STN-DBS, focusing on disability milestones such as falls, freezing, hallucinations, dementia, and institutionalization. The significance of this study lies in its extensive follow-up, offering a comprehensive view of STN-DBS outcomes.
Study Design and Methodology
This longitudinal, retrospective study included patients who underwent STN-DBS between 2006 and 2012, with a minimum follow-up of 8 years. It employed rigorous analytical methods like Cox proportional hazards regression and competing risk analyses. This model is key for understanding how different variables, such as age at surgery or type of symptoms, influence patient outcomes over time, providing a nuanced view of the effectiveness of treatments. The study’s meticulous design enhances the reliability of its findings, shedding light on the progression of Parkinson’s Disease following DBS.
Key Findings and Results
The study revealed a relatively low long-term mortality rate — 16% overall among 109 patients — with motor disabilities (particularly freezing of gait and falls) occurring earlier and more frequently than cognitive ones. Intriguingly, it found that age at surgery was a critical predictor of these milestones. The results emphasize the complexity of PD progression and the impact of STN-DBS, highlighting the necessity of considering patient-specific factors in treatment plans.
Interpreting Results and Comparisons with Other Studies
The results suggest that earlier intervention with STN-DBS could be more beneficial, altering the traditional approach to PD treatment. This study substantially contributes to understanding PD’s trajectory and refining therapeutic strategies.
Comparing these results with similar studies reveals that DBS improves survival in severe Parkinson’s cases and reduces the need for admission to nursing facilities. Despite its efficacy in controlling motor symptoms, DBS does not significantly alter the overall progression of the disease. These results underscore the need for integrated therapeutic approaches to manage Parkinson’s disease effectively.
Gondola AMPS: Complementing DBS in Parkinson’s Disease
As the study highlights the necessity of integrating multiple therapies for Parkinson’s Disease (PD), we turn the attention to Automated Mechanical Peripheral Stimulation (AMPS), a novel noninvasive approach to target PD walking symptoms, including – for the first time ever – freezing of gait (FOG). AMPS is delivered via the Gondola medical device and emerges as a promising option to tackle walking and balance symptoms that tend not to respond to traditional therapeutic approaches, drugs, or DBS. AMPS specifically addresses symptoms for which DBS may offer limited or no relief: integrating AMPS with DBS could potentially enhance overall treatment efficacy, especially in mitigating motor symptoms like FOG, and help prevent falls.
Future of PD Treatment: Combining AMPS and DBS
The correlation between the findings of the DBS and AMPS studies suggests a synergistic potential in treating Parkinson’s disease. By combining the central nervous system-focused outcomes of DBS with the unique benefits deriving from the non-invasive peripheral AMPS therapy, a more holistic treatment approach could emerge. This could significantly enhance patient mobility and overall quality of life, especially in addressing the challenging gait-related symptoms of Parkinson’s disease.
This dual approach could offer a more comprehensive management of PD, improving patient’s quality of life and ultimately reducing the overall cost of care and the caregivers’ burden.
