From: VA Media Relations <[log in to unmask]>
To: [log in to unmask]
Date: Tue, 13 Jan 2009 13:46:30 -0500
Subject: Release - VA-NIH Study Offers Hope for Parkinson's Patients


VA-NIH Study Offers Hope for Parkinson's Patients

Study Says Deep-Brain Stimulation Has Benefits

WASHINGTON (January 13, 2009) -- Electrical stimulation of the brain -- a
treatment in which a pacemaker-like device sends pulses to electrodes implanted
in the brain -- is riskier than drug therapy but may hold significant
benefits for those with Parkinson's disease who no longer respond well to
medication alone.
That is the conclusion of researchers from the Department of Veterans
Affairs (VA) and National Institutes of Health (NIH) who conducted a six-year study
comparing deep-brain stimulation (DBS) to medication, along with speech,
physical or occupational therapy, given as needed. The results of the trial,
the largest of its kind to date, appear in the January 7 Journal of the
American Medical Association (JAMA).
"Deep-brain stimulation offers hope for a large number of patients with
advanced Parkinson's disease who suffer from complications of long-standing
medication therapy," said Secretary of Veterans Affairs Dr. James B. Peake. "This
finding could mean improved quality of life for some of our patients."
The study included 255 Parkinson's patients at seven VA medical centers and
six university hospitals. The VA sites were Portland, Ore., Seattle, San
Francisco, Los Angeles, Houston, Richmond, Va., and Philadelphia, all members of
VA's network of Parkinson's Disease Research, Education and Clinical Centers.
The JAMA article also noted VA's nationwide system of hospitals and
specialized centers of excellence make the Department uniquely capable of conducting
such large, multi-site trials of new therapies and medical devices. VA's
patient population is especially suited for trials of treatments for chronic
disease in the elderly.
Patients who took part in the study were on medication but are no longer
seeing improvements in symptoms such as tremors or stiffness. Many were also
developing side effects from the drugs, such as involuntary face, arm or leg
movements.
Researchers followed the patients for six months, finding:
* Patients who received DBS gained an average of 4.6 hours per day of good
motor control and few or no involuntary movements, compared with no gain for
those on medical therapy alone;
      * 71 percent of DBS patients showed significant gains in motor
function, compared with only 32 percent of drug therapy patients; and
* Serious adverse side effects were nearly four times more common in the DBS
group, but almost all of these effects in both groups were resolved during
the six-month study. The most common side effects from DBS were infections,
falls, depression, gait and balance problems, and pain.
Lead authors and study co-chairs were Frances Weaver, PhD, a researcher with
the Center for Management of Complex Chronic Care at the Hines VA Hospital
near Chicago, and Dr. Kenneth Follett, a neurosurgeon at the Omaha VA Medical
Center and University of Nebraska. They emphasize that besides the higher
likelihood of serious side effects with DBS compared with drug therapy, another
drawback of the procedure is that, although it generally improves movement,
it does little to help other Parkinson's symptoms such as depression, decline
in mental ability, gait and balance problems, and trouble with
gastrointestinal, urinary or sexual function.
"The results of the study should not be over- or under-stated," said Dr.
Michael Kussman, VA's Under Secretary for Health. "Still, there are many good
candidates for DBS among patients with Parkinson's disease whom we treat in
VA."
The trial was sponsored by VA's Cooperative Studies Program and the National
Institute of Neurological Disorders and Stroke, part of the National
Institutes of Health. Additional support came from Medtronic, which makes the DBS
system used in the study.
Parkinson's disease, a progressive neurological disorder, affects some 1.5
million Americans, with 50,000 new cases diagnosed annually. VA treats at
least 40,000 veterans with the disorder each year. Most patients are over age
50, but some forms of the disease can strike younger adults.




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