• Neuromodulation · Nov 2011

    Case Reports Randomized Controlled Trial

    Deep brain stimulation for early-stage Parkinson's disease: an illustrative case.

    • Chandler E Gill, Laura A Allen, Peter E Konrad, Thomas L Davis, Mark J Bliton, Stuart G Finder, Michael G Tramontana, C Chris Kao, Michael S Remple, Courtney H Bradenham, and P David Charles.
    • Stritch School of Medicine, Loyola University, Maywood, IL, USA.
    • Neuromodulation. 2011 Nov 1;14(6):515-21; discussion 521-2.

    ObjectivesSubthalamic nucleus (STN) deep brain stimulation (DBS) is an effective intervention in advanced Parkinson's disease (PD), but its efficacy and safety in early PD are unknown. We are conducting a randomized pilot trial investigating DBS in early PD. This report describes one participant who received bilateral STN-DBS.Materials And MethodsThirty subjects have been randomized to either optimal drug therapy (ODT) or DBS + ODT. Microelectrode recordings from the STN and substantia nigra are collected at implantation. The Unified Parkinson's Disease Rating Scale Motor Subscale (UPDRS-III) is administered in the ON and OFF states semi-annually and neuropsychological function and quality of life are assessed annually. We describe a 54-year-old man with a two-year history of PD who was randomized to DBS + ODT and followed for two years.ResultsThe subject showed a lower STN to substantia nigra ratio of neuronal activity than advanced PD patients, and higher firing rate than non-PD patients. The subject's total UPDRS and UPDRS-III scores improved during the two-year follow-up, while his OFF UPDRS-III score and levodopa equivalent daily dose increased. Quality of life, verbal fluency, and verbal learning improved. He did not experience any serious adverse events.ConclusionsThis report details the first successful application of bilateral STN-DBS for early-stage PD during a clinical trial.© 2011 International Neuromodulation Society.

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