Neurosurgery Effective For Parkinson's Patients Not Responding To Drug
Therapy
LONDON, UK -- November 12, 1999 -- Brain surgery for patients with
advanced Parkinson's disease is an effective treatment for those who
have an unsatisfactory response to pharmacological treatments, say
researchers in this week's issue of The Lancet. Dr. Rob de Bie and
colleagues from the Academic Medical Centre, Amsterdam, the Netherlands,
report the findings of a randomised multicentre trial to test whether
Parkinson's patients would benefit from an operation called unilateral
pallidotomy (destruction of one side of the globus pallidus, an area of
the brain affected in Parkinson's diseases). Dr. N. Quinn, in his
commentary on the paper says, "the recent resurgence in functional
stereotactic neurosurgery is the most important advance in Parkinson's
disease since the introduction of levodopa treatment in 1967".
Dr. de Bie's team enrolled 37 patients with advanced Parkinson's disease
who had, despite optimum drug treatment, at least one of the following
symptoms: severe response fluctuations, dyskinesias, painful dystonias,
or bradykinesia. Patients were randomly assigned to unilateral
pallidotomy within one month (cases) or to unilateral pallidotomy after
the primary outcome assessment six-months later (control). The primary
outcome was the difference between the groups in median changes on the
motor examination section of the unified Parkinson's disease rating
scale (UPDRS 3) score, done when the patients were immobile (the 'off'
phase of Parkinson's disease). The median UPDRS 3 off score of the cases
improved from 47 to 32.5, whereas that of control patients slightly
worsened from 52.5 to 56.5. There was also improvement in the cases on
other rating scales. Two cases had major adverse effects.
The researchers say, "Unilateral pallidotomy is an effective treatment
in patients with advanced Parkinson's diseases, who have an
unsatisfactory response to pharmacological treatment...adverse effects,
however, can be severe and this factor has to be considered when
assessing patients for surgical treatment."
Related Link: The Lancet.
Copyright © 1999 P\S\L Consulting Group Inc.
~~~~
Judith Richards, London, Ontario, Canada
[log in to unmask]
^^^^
\ /
\ | / Today’s Research
\\ | // ...Tomorrow’s Cure
\ | /
\|/
`````
