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from this article it would appear to be "improved motor functions and quality of life" - more "ON" time. since I don't take any PD meds its impossible to tell for me. Tremor was the only symptom it definitely helped. I don't know how bad my other symptoms would be without DBS. ray Rayilyn Brown Director AZNPF Arizona Chapter National Parkinson Foundation [log in to unmask] -------------------------------------------------- From: "kbachn" <[log in to unmask]> Sent: Sunday, January 11, 2009 4:06 AM To: <[log in to unmask]> Subject: Re: DBS for advanced PD > what are the "behavioral effects of stimulation" > > tks > > > ----- Original Message ----- > From: "rayilynlee" <[log in to unmask]> > To: <[log in to unmask]> > Sent: Saturday, January 10, 2009 2:25 PM > Subject: DBS for advanced PD > > >> Deep Brain Stimulation Treatment For Advanced Parkinson's Disease >> Patients Provides Benefits, Risks >> ScienceDaily (Jan. 9, 2009) - Patients with advanced Parkinson disease >> (PD) who received deep brain stimulation treatment had more improvement >> in movement skills and quality of life after six months than patients who >> received other medical therapy, but also had a higher risk of a serious >> adverse events, according to a new study. >> Deep brain stimulation is a surgical treatment involving the implantation >> of electrodes that send electrical stimulation to specific parts of the >> brain to reduce involuntary movements and tremors. It is the surgical >> intervention of choice when PD motor (movement) complications are >> inadequately managed with medications, according to background >> information in the article. "However, recent reports highlighting >> unexpected behavioral effects of stimulation suggest that deep brain >> stimulation, while improving motor function, may have other less >> desirable consequences," the authors write. They add that there are few >> randomized trials comparing treatments, and most studies exclude older >> patients. >> Frances M. Weaver, Ph.D., of Hines VA Hospital, Hines, Ill., and >> colleagues conducted a randomized trial to compare the benefits and risks >> of deep brain stimulation with those of best medical therapy for >> patients, of a wide age range, with PD. A total of 255 patients with PD >> were enrolled; 25 percent were age 70 years or older. The participants >> were randomized to receive bilateral deep brain stimulation with leads of >> the stimulation device implanted in the following locations of the brain: >> subthalamic nucleus (n = 60) or globus pallidus (n = 61); or received >> best medical therapy (n = 134), which included management by movement >> disorder neurologists, who monitored medication use and >> nonpharmacological therapy (e.g., physical, occupational, and speech >> therapy). >> The researchers found that at 6 months, deep brain stimulation patients >> gained an average of 4.6 hours per day of on time (the time of good >> symptom control or unimpeded motor function) without troubling dyskinesia >> (involuntary movements), while the average change for the best medical >> therapy group was 0 hours. Motor function improved significantly with >> deep brain stimulation compared with best medical therapy, with 71 >> percent of deep brain stimulation patients vs. 32 percent of best medical >> therapy patients experiencing clinically meaningful motor function >> improvements at 6 months, while 3 percent of deep brain stimulation >> patients and 21 percent of best medical therapy patients had clinically >> worsening scores. >> Compared with patients in the best medical therapy group, patients in the >> deep brain stimulation group experienced significant improvements in the >> summary measure of quality of life and on 7 of 8 PD quality-of-life >> scores. Neurocognitive testing revealed small decrements in some areas of >> information processing for patients receiving deep brain stimulation vs. >> best medical therapy. >> The overall risk of experiencing a serious adverse event was 3.8 times >> higher in deep brain stimulation patients than in best medical therapy >> patients. Forty-nine deep brain stimulation patients (40 percent) >> experienced 82 serious adverse events. Fifteen best medical therapy >> patients (11 percent) experienced 19 serious adverse events. The most >> common serious adverse event was surgical site infection, with other >> serious adverse events including nervous system disorders, psychiatric >> disorders, device-related complications and cardiac disorders. >> "The clinical significance of the adverse events and minor neurocognitive >> changes observed in patients in the deep brain stimulation group and, >> more importantly, whether patients who undergo deep brain stimulation >> view improvement in motor function and quality of life as outweighing >> adverse events, remain to be explored. More detailed analyses of adverse >> events and neurocognitive functioning following the conclusion of phase 2 >> of this study will shed light on these issues. Caution should be >> exercised, however, against overstating or understating the risks of deep >> brain stimulation for patients with PD. Physicians must continue to weigh >> the potential short-term and long-term risks with the benefits of deep >> brain stimulation in each patient," the authors conclude. >> Editorial: Neurostimulation for Parkinson Disease >> In an accompanying editorial, Günther Deuschl, M.D., Ph.D., of the >> Universitätsklinikum Schleswig-Holstein, Kiel, Germany, comments on the >> findings of Weaver and colleagues. >> "Although deep brain stimulation is the most important innovation for >> treatment of advanced PD since the discovery of levodopa [drug used to >> treat PD], many questions are still unanswered. For instance, the optimal >> timing for the implantation is unknown. The majority of patients undergo >> deep brain stimulation surgery more than 10 years after disease onset >> when the patients are already incapable of working and when the >> disease-related psychosocial decline has already begun. As quality of >> life is improved with this treatment it may improve psychosocial >> functioning in general for these advanced stages. With the aging of the >> general population, PD will become even more common and patients with PD >> will get older. Therefore, the present results showing similar efficacy >> and tolerability of deep brain stimulation in younger and older patients >> must be replicated because it is at variance with some other reports >> demonstrating lower rates of operative and postoperative complications in >> younger patients." >> "Overall the results of this important study by Weaver et al have >> convincingly confirmed the 6-month efficacy of deep brain stimulation for >> advanced PD in the largest patient group studied thus far. However, this >> study, along with previous research on this therapy, shows that such >> progress cannot be made without costs in terms of adverse effects." >> >> JAMA and Archives Journals (2009, January 9). Deep Brain Stimulation >> Treatment For Advanced Parkinson's Disease Patients Provides Benefits, >> Risks. ScienceDaily. Retrieved January 10, 2009, from >> http://www.sciencedaily.com /releases/2009/01/090106161510.htm >> >> Rayilyn Brown >> Director AZNPF >> Arizona Chapter National Parkinson Foundation >> [log in to unmask] >> ---------------------------------------------------------------------- >> To sign-off Parkinsn send a message to: >> mailto:[log in to unmask] >> In the body of the message put: signoff parkinsn > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: > mailto:[log in to unmask] > In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn