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Deep Brain Stimulation Works in Two Sites for Parkinson's Disease
Date:6/2/2010

Choice of area to pinpoint can be tailored to individual patients, researchers say ,,

WEDNESDAY, June 2 (HealthDay News) -- People suffering from Parkinson's disease can benefit from deep brain stimulation in either one of two sites in the brain, a new study finds.

The Veterans Affairs researchers compared two different targets in the brain for deep brain stimulation -- the subthalamic nucleus (STN) and the globus pallidus interna (GPi) -- both of which affect motor function. The procedure involves placing a fine wire into either of the two areas, after which an implanted battery delivers a finely tuned electrical current to stimulate the brain, often resulting in dramatic improvement in motor function.

"Most of the neurosurgery field has been using the STN target, with little strong evidence that it was the best target for stimulation," said researcher Frances Weaver, director of the Center for Management of Complex Chronic Care at Hines VA Hospital in Illinois.

"But recent reports suggest that there may be some negative consequences of STN targeting, including cognitive and psychological changes," she added.

The report is published in the June 3 issue of the New England Journal of Medicine.

For this study, researchers compared the STN and GPi targets in a randomized trial and looked at patient outcomes. In the trial, 299 patients were assigned to either STN or GPi deep brain stimulation.

Weaver's team found that patients improved equally in motor function, regardless of which target was used.

Overall, about half of the patients had serious side effects. The most common was infection at the incision site. By the end of the two-year study, 99 percent of these side effects were resolved.

"The decision as to which target in the brain to stimulate to treat Parkinson's disease should consider the other symptoms and problems of Parkinson's disease," Weaver said. F
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