Patients with Parkinson's benefit from a brain pacemaker

How a brain pacemaker should reduce behavioral problems

Gambling, sex, buying or eating are possible behavioral problems that can be triggered by Parkinson's drugs. A brain pacemaker allows patients with the neurological disease to have better control over their impulses - compared to patients who rely only on drug therapy. This emerges from an extensive study by a German-French research team. Therapy involves implanting thin electrodes into the brain, which deliver electrical impulses to the desired target area to stimulate them.

Parkinson's disease is one of the most common neurological diseases with more than four million people worldwide. "Due to the increasing average age, the number of people affected is expected to double to 8.7 million by the year 2030," explains neurologist Professor Dr. med. Lars Timmermann in a press release of the Philipps University Marburg, which participated in the study. Working groups from 18 European universities came together for the study. The results were published in the March issue of the journal "Lancet Neurology".

A brain pacemaker is designed to reduce the amount of drugs that can cause behavioral problems in Parkinson's patients. (Image: rob3000 / fotolia.com)

Parkinson's drugs can cause behavioral problems

According to Timmermann, the symptoms of Parkinson's disease are easily treatable by modern medication. "The drugs, however, often cause serious behavioral problems, especially in young patients," said the neurologist. These disorders include, for example, gambling addiction, too much desire for sex, eating disorders and morbid spending spree.

The treatment starts directly in the brain

Symptoms of Parkinson's disease, such as tremor, slowing movement, or muscle stiffness, are due to altered nerve cell activity in low-lying regions of the brain. The approach of the brain pacemaker is therefore to start directly on deep brain nuclei and thus significantly reduce the administration of medication. "We wanted to find out if deep brain stimulation also reduces behavioral problems," explains co-author Carmen Schade-Brittinger, who heads the Coordinating Center for Clinical Trials at the Philipps University of Marburg.

Brain stimulation can improve the quality of life of those affected

In the study, 251 patients were followed over a two-year period. On average, the subjects already suffered from the disease for eight years. The first results were already seen in a previous study by the team, which reported that the quality of life of patients with Parkinson's improved when receiving early brain stimulation in addition to medication. In the current study, the scientists again addressed the issue using newly developed psychiatric assessment standards.

The results speak for themselves

According to the physicians, the behavioral problems of the patients were reduced without showing any other neurological abnormalities such as apathy, depression or anxiety. "Our findings allow a change of course in the treatment," summarizes Timmermann. In the previous therapy, the occurrence of behavioral disorders was considered an obstacle to surgical intervention. The current study results suggest, however, that in case of loss of control such interventions for deep stimulation make sense.

Success of the brain pacemaker depends on the success of the operation

"The success of a brain pacemaker treatment is always dependent on optimal surgery," explains Professor. Christopher Nimsky, Head of Marburg Neurosurgery, at which such interventions are made. So far, only patients under the age of 61 years have been included in the study. "Whether the results are to be transferred to all age groups has to be reviewed in future studies," says Timmermann.

About Parkinson's research

Parkinson's disease belongs to the so-called neurodegenerative disease in which defective proteins in the central nervous system influence the movement of those affected. These so-called Lewy bodies are the typical sign of the disease. Just recently, another study on Parkinson's disease revealed that excess calcium leads to the formation of toxic clusters. Researchers at the University of Cambridge found that excess levels of the mineral in brain cells can lead to the formation of toxic clusters involved in the development of Parkinson's disease. (Vb)