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Neurologists Can Improve 'Deep Brain' Therapy for Parkinson's
 21:43:34 EDT Jul 12, 2006
 WEDNESDAY, July 12 (HealthDay News) - Neurologists with expertise in a
therapy called deep brain stimulation can help improve outcomes for
Parkinson's disease patients undergoing the treatment, a Canadian study
finds.
Deep brain stimulation is a surgical procedure in which electrodes are
implanted into the brain to electronically stimulate neurological areas
controlling movement. The procedure is used to treat Parkinson's symptoms
such as tremors, stiffness and difficulty walking, and is the most effective
surgical treatment for advanced Parkinson's, according to background
information in the study.
The treatment requires intensive patient management, such as adjustment of
electrical currents and patient medication dosages. However, at many medical
centers in North America, these duties are assigned to health workers - such
as surgical nurses, fellows or neurophysiologists - who do not have extensive
experience in caring for Parkinson's patients, the study authors explained.
In their study, the team from the University of Toronto followed outcomes in
44 Parkinson's patients treated with deep brain stimulation to see whether
treatment could be improved through the direct involvement of a neurologist.
The patients in the study had already undergone deep brain stimulation
treatment for an average of 3.5 years. For this study, the neurologist became
directly involved in the treatment - for example, making adjustments to
electrical currents during the procedure and to the doses of medication
received by patients after the procedure.
Patients' Parkinson's disease symptoms were assessed before and after (an
average of five months, with a range of one hour to 14 months) they began
this reprogrammed treatment.
The study found that 54.6 percent (24) of the patients showed additional
improvement in their Parkinson's symptoms, while 36.4 percent (16) remained
unchanged, and 9.1 percent (4) experienced worsened symptoms. Those who
showed improvement had fewer tremors, less rigidity and slowness of movement
(bradykinesia), and reductions in their medication dosages.
The four patients with worsened symptoms suffered more speech and gait
problems. They were put back on their original treatment settings.
The findings were published in the July 11 online issue of the Archives of
Neurology, and are expected to be in the September print issue of the
journal.

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