Sweet spot

By • Published: June 8th, 2009
Category: Health in a Heartbeat

Doctors may be able to tailor a specialized form of brain surgery to more closely match the needs of Parkinson patients, according to results from the first large-scale comparison of two target areas of deep brain stimulation surgery, or D-B-S.

University of Florida researchers found that D-B-S effectively treated movement symptoms such as tremors, stiffness and slowness.

However, depending on the target location, D-B-S also produced unique effects in patients’ moods and mental sharpness.

D-B-S uses a medical device surgically implanted in a patient’s brain and connected to a power pack in the shoulder area. It delivers electrical pulses to targeted areas of the brain via very thin wires called “leads.”

Currently, in almost all cases worldwide, the leads are implanted in a brain region known as the subthalamic [sub-tha-LA-mic] nucleus. But the nearby globus pallidus interna, [glow-bus pal-id-us intern-ah] or Gpi [G-P-eye], may again emerge as a viable target, especially for patients with mood and cognitive issues.

Forty-five volunteers with Parkinson’s disease completed the study.

Twenty-three received leads to the GPi and twenty-two to the subthalamic nucleus.

Generally, the target choice produced no major differences in motor function, mood or cognition in the patients.

However, patients whose leads were implanted in the subthalamic nucleus, the most common surgery target, did have mildly increased problems with verbal fluency and mood.

Both targets are FDA-approved and provide excellent outcomes for Parkinson patients.

But with more study, doctors might find it is important to consider the lesser-used target for patients with severe cognitive difficulties.