Less-invasive method of brain stimulation helps patients with Parkinson's disease

October 16, 2012

Electrical stimulation using extradural electrodes—placed underneath the skull but not implanted in the brain—is a safe approach with meaningful benefits for patients with Parkinson's disease, reports the October issue of Neurosurgery, official journal of the Congress of Neurological Surgeons.

The technique, called extradural motor cortex stimulation (EMCS), may provide a less-invasive alternative to electrical (DBS) for some with the movement disorder Parkinson's disease. The study was led by Dr. Beatrice Cioni of Catholic University, Rome.

Study Shows Safety and Effectiveness of Extradural Brain Stimulation

The researchers evaluated EMCS in nine patients with Parkinson's disease. Over the past decade, DBS using implanted in specific areas within the brain has become an accepted treatment for Parkinson's disease. In the EMCS technique, a relatively simple surgical procedure is performed to place a strip of four electrodes in an "extradural" location—on top of the tough membrane (dura) lining the brain.

The electrodes were placed over a brain area called the motor cortex, which governs voluntary muscle movements. The study was designed to demonstrate the safety of the EMCS approach, and to provide preliminary information on its effectiveness in relieving the various types of movement abnormalities in Parkinson's disease.

The electrode placement procedure and subsequent electrical stimulation were safe, with no surgical complications or other . In particular, the patients had no changes in intellectual function or behavior and no or other signs of epilepsy.

Extradural stimulation led to small but significant and lasting improvements in control of voluntary movement. After one year, motor symptoms improved by an average of 13 percent on a standard Parkinson's disease rating scale, while the patient was off medications.

'Remarkable' Improvement in Walking and Related Symptoms

The improvement appeared after three to four weeks of and persisted for a few weeks after stimulation was stopped. In one case where the stimulator was accidentally switched off, it took four weeks before the patient even noticed.

Extradural stimulation was particularly effective in relieving the "axial" symptoms of Parkinson's disease, such as difficulties walking. Patients had significant improvement in walking ability, including fewer problems with "freezing" of gait. The EMCS procedure also reduced tremors and other abnormal movements while improving scores on a quality-of-life questionnaire.

Although DBS is an effective treatment for Parkinson's disease, it's not appropriate for all patients. Some patients have health conditions or old age that would make surgery for electrode placement too risky. Other patients—including four of the nine patients in the new study—are eligible for DBS but don't want to undergo electrode placement surgery.

The concept of extradural stimulation is not new, but previous studies have had important limitations, with inconsistent results. The new report is the largest study of EMCS performed using a standard technique in a well-defined group of patients.

The findings show that extradural stimulation is not only safe for patients with Parkinson's disease, but also effective in improving movement disorder symptoms—with "remarkable effects on axial symptoms," according to Dr. Cioni and colleagues. Although the improvement is not as great as with DBS, the researchers believe that EMCS "should be considered as an alternative option" for at least some groups of patients. Further studies, including long-term follow-up, are underway.

Explore further: Deep brain stimulation effects may last for 10 years in patients with Parkinson's disease

Related Stories

Deep brain stimulation effects may last for 10 years in patients with Parkinson's disease

August 8, 2011
One decade after receiving implants that stimulate areas of their brains, patients with Parkinson's disease (PD) appear to sustain improvement in motor function, although part of the initial benefit wore off mainly because ...

DBS operation for Parkinson's disease performed inside iMRI

September 19, 2011
Henry Ford Hospital became the third hospital in the United States to perform a Deep Brain Stimulation (DBS) procedure inside an Intraoperative Magnetic Resonance Imaging scanner, or iMRI.

'Brain pacemaker' effective for years against Parkinson's disease

June 20, 2012
A "brain pacemaker" called deep brain stimulation (DBS) remains an effective treatment for Parkinson's disease for at least three years, according to a study in the June 2012 online issue of Neurology, the medical journal ...

Recommended for you

Investigating the most common genetic contributor to Parkinson's disease

October 19, 2017
LRRK2 gene mutations are the most common genetic cause of Parkinson's disease (PD), but the normal physiological role of this gene in the brain remains unclear. In a paper published in Neuron, Brigham and Women's Hospital ...

Scientists solve 3-D structure of key defense protein against Parkinson's disease

October 5, 2017
Scientists at the University of Dundee have identified the structure of a key enzyme that protects the brain against Parkinson's disease.

Novel protein interactions explain memory deficits in Parkinson's disease

September 26, 2017
A study published in the journal Nature Neuroscience describes the identification of a novel molecular pathway that can constitute a therapeutic target for cognitive defects in Parkinson's disease. The study showed that abnormal ...

Psychosis in Parkinson's dementia—new treatment provides hope

September 25, 2017
New research involving King's College London and the University of Exeter has highlighted the benefits of a promising new treatment which could relieve psychosis in thousands of people with dementia related to Parkinson's ...

Bicycling 'overloads' movement networks with Parkinson's

September 23, 2017
(HealthDay)—Bicycling suppresses abnormal beta synchrony in the Parkinsonian basal ganglia, according to a study published online Sept. 11 in the Annals of Neurology.

Researchers find new path to promising Parkinson's treatment

September 19, 2017
Three researchers at The University of Alabama are part of work that is leading to a new direction for drug discovery in the quest to treat Parkinson's disease.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.