Deep Brain Stimulation May Slow Tremor Progression

Deep brain stimulation may slow the progression of tremor if performed in early Parkinson’s disease.

APDA funding is helping further the efforts to find out more.

New results, published in the June 29, 2018, online issue of Neurology suggest that deep brain stimulation (DBS) may slow the progression of tremor if performed early on in the Parkinson’s disease (PD) course. This data implies that DBS may not just treat the symptoms of PD, but act to alter the course of the disease, by slowing down the progression of tremor.

About the study

The results are part of a study that enrolled 30 early-PD patients at Vanderbilt University Medical Center in Nashville, TN over the years of 2006-2014 to either receive DBS plus optimal medical therapy or optimal medical therapy alone. The patients were followed every six months for the first two years, and then continued to be followed yearly. These patients were different than the typical patients receiving DBS, in that when they received the surgery, they had been diagnosed less than four years prior and they did not have the classic problems from Levodopa treatment, such as dyskinesias and motor fluctuations that typically drive patients to DBS. The initial data from this trial was published and showed that DBS was well-tolerated in early PD.

At each evaluation, the patients were examined at their best (on medication and/or DBS treatment) and they were also examined off their treatment (after stopping medication and/or DBS treatment for one week). An intriguing result that has emerged from this analysis is that rest tremor while off of all treatment was improved in the group that received DBS as compared to the group that did not. In addition, patients who had DBS were much less likely to have tremor move to previously unaffected limbs than patients who did not have DBS.

This group of patients continues to be studied as their disease progresses. It is now more than 10 years since the start of enrollment, about the time that some of the patients may have received DBS under traditional criteria. All data collected from this group is unique as this is the only study of long term effects of DBS when performed on an early-PD patient population.

APDA funding is helping make further research possible

This Vanderbilt University group is collaborating with other DBS researchers in analyzing the data from this small trial in order to design a larger trial to study DBS in early PD. The Disease Modification in Early Parkinson Disease Consortium has been convening since 2014, and APDA has been a proud sponsor and participant in this effort. Vanderbilt will lead the multi-center effort which will include 17 other centers in the United States and will begin in 2019.