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

Tapeworm drug could lead the fight against Parkinson's disease

December 12, 2017
Researchers at Cardiff University, in collaboration with the University of Dundee, have identified a drug molecule within a medicine used to treat tapeworm infections which could lead to new treatments for patients with Parkinson's ...

High-intensity exercise delays Parkinson's progression

December 11, 2017
High-intensity exercise three times a week is safe for individuals with early-stage Parkinson's disease and decreases worsening of motor symptoms, according to a new phase 2, multi-site trial led by Northwestern Medicine ...

Changes in diet may improve life expectancy in Parkinson's patients

November 24, 2017
New research from the University of Aberdeen shows that weight loss in people with Parkinson's disease leads to decreased life expectancy, increased risk of dementia and more dependency on care.

Good cells gone bad: Scientists discover PINK-SNO

November 21, 2017
A new study from The Scripps Research Institute (TSRI) is the first to show precisely how a process in nerve cells called the S-nitrosylation (SNO) reaction—which can be caused by aging, pesticides and pollution—may contribute ...

Genetic defects in the cell's 'waste disposal system' linked to Parkinson's disease

November 14, 2017
An international study has shed new light on the genetic factors associated with Parkinson's disease, pointing at a group of lysosomal storage disorder genes as potential major contributors to the onset and progression of ...

Parkinson's disease: A looming pandemic

November 13, 2017
New research shows that the number of people with Parkinson's disease will soon grow to pandemic proportions. In a commentary appearing today in the journal JAMA Neurology, University of Rochester Medical Center neurologist ...

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.