People living with Parkinson’s face a range of motor and non-motor symptoms, some of which can be managed with dopaminergic medication. However, these medications have been shown to have a variable effect on tremors and some individuals experience medication-related side effects which can impact their quality of life (QoL).
Deep Brain Stimulation (DBS) is an innovative treatment used for managing motor symptoms without medication-related side effects. DBS involves placing electrodes in specific areas of the brain to produce electrical impulses that help alleviate symptoms of neurodegenerative diseases such as Parkinson’s. To be eligible for DBS treatment, a person needs to have had Parkinson’s for over four years and can be benefitting from medication but faces motor complications such as significant “off” periods (when symptoms return because medication isn’t working well) and/or dyskinesia (uncontrolled, involuntary movements).
DBS has been commonly used as a second-line treatment for Parkinson’s after medication has been tried. More recently, some experts have proposed earlier use of DBS to prevent medication-related side effects altogether. In fact, some trials have shown improved QoL when DBS was implemented prior to the onset of motor symptoms.
The main challenge of early DBS treatment is that the course of Parkinson’s remains unclear and is variable in individuals. The Parkinson’s Progression Markers Initiative (PPMI) is an international multicenter study led by The Michael J. Fox Foundation that aims to uncover biomarkers that would predict the disease course. One way these biomarkers can be useful is by offering early insight into which individuals would be eligible for or likely benefit from DBS in the future. is an international multicenter study led by The Michael J. Fox Foundation that aims to uncover biomarkers that would predict the disease course. One way these biomarkers can be useful is by offering early insight into which individuals would be eligible for DBS in the future.
Parkinson Canada-funded researchers Dr.Stefan Lang, Dr. Lorraine Kalia, and Dr.Suneil Kalia, among other experts, utilized data from PPMI to measure Parkinson’s progression in two separate cohorts of patients: those who later received DBS (DBS+) and those who did not (DBS-). They discovered that the most significant baseline predictors of which Parkinson’s patients would undergo DBS surgery in the future were: younger age at symptom onset, less severe initial disease stage, increased presence of tremor at diagnosis, as well as other markers.
This study offers a unique window of opportunity to predict patients earlier on who would be eligible for DBS. Understanding and predicting the early course of Parkinson’s and responding with early DBS treatment can have profound benefits to the QoL of those living with Parkinson’s, including but not limited to avoidance of medication-related side effects.