symptoms of parkinsons disease : Neurologists Can Improve 'Deep Brain' Therapy for Parkinson's

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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