Clinical Topics

Deep brain simulation extends Parkinson’s survival

by U.S. Medicine

July 15, 2018

HINES, IL — Deep brain stimulation (DBS) not only improves motor function in patients with Parkinson’s disease, as demonstrated in earlier studies, it also appears to extend life, according to new VA research.

A study conducted by a team from the Edward Hines Jr. VAMC documented a modest survival advantage in Parkinson’s patients who received stimulation through an implanted device, compared to similar patients treated only with medication. Their findings were published in the journal Movement Disorders.1

“Overall, DBS surgery has been viewed quite positively by both patients and providers,” explained lead author Frances Weaver, PhD, MA. “There is an immediate effect on patients who have DBS on their motor function —the dyskinesia is either gone or greatly reduced. The patient can move around and do things they hadn’t been able to.”

The researchers noted, however, that few studies have looked at whether life expectancy is improved because of the treatment. To remedy that, they analyzed data for 611 veterans, average age 69, with Parkinson’s disease and an implanted deep brain stimulation device implanted. Administrative files from VA and Medicare from 2007 to 2013 were used for the research.

Each DBS patient was paired with a clinically and demographically similar non-DBS patient —for example, in terms of age and symptom severity —and tracked survival from the date when surgery either took place for the DBS group or might have theoretically taken place for the medication-only group. Results indicated that patients treated with deep brain stimulation survived an average of 6.3 years after the surgery vs.5.7 years for the medication-only patients.

Specifically, veterans with Parkinson’s disease who received DBS had a longer survival measured in days than a matched group of veterans who did not undergo DBS (mean = 2291.1 [standard error = 46.4] days [6.3 years] vs. 2063.8 [standard error = 47.7] days [5.7 years]; P = .006; hazard ratio = 0.69 [95% confidence interval 0.56-0.85]).

The study also found that mean age at death was similar for both groups (76.5 [standard deviation = 7.2] vs. 75.9 [standard deviation = 8.4] years, P = .67), respectively, with Parkinson’s the most common cause of death.

Study authors pointed out that medication helps manage symptoms of Parkinson’s but, thus far, not been shown to improve survival for those with Parkinson’s. “The surgery may get patients back to where they were when the medication was effective. That is, DBS is typically as effective as the medication —if the medication was still working,” Weaver said.

1Weaver FM, Stroupe KT, Smith B, Gonzalez B, Huo Z, Cao L, Ippolito D, Follett KA. Survival in patients with Parkinson’s disease after deep brain stimulation or medical management. Mov Disord. 2017 Dec;32(12):1756-1763. doi: 10.1002/mds.27235. Epub 2017 Nov 18. PubMed PMID: 29150873.

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