THE EFFECT OF DEEP BRAIN STIMULATION (DBS) ON PARKINSON'S DISEASE

4th July 2013 - New research

Ideggyogy Sz. [2013] 66 (3-4) : 115-120 (G.Tamás, A.Takáts, P.Radics, I.Rózsa, E.Csibri, G.Rudas, P.Golopencza, L.Entz, D.Fabó, L.Eross) 

Researchers assessed the effect of Deep Brain Stimulation (DBS) on the different types of symptoms experienced in Parkinson's Disease. Deep Brain Stimulation  (DBS) involves the use of electrodes that are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS requires careful programming of the stimulator device.

The major Parkinson's Disease symptom score (the Unified Parkinson's Disease Rating Scale) decreased by 70%. Patient condition improved according to the Hoehn-Yahr scale, approximately by two stages. Twelve hours after the withdrawal of Parkinson's Disease drugs execution of daily activity improved by 57% and motor functions developed by 79%. Duration of dyskinesias decreased by 62%. Duration of akinesia (loss of movement) diminished by 87%. Quality of life rose by 41%. Neuropsychological tests detected improvement in verbal memory. The dosage of Parkinson's Disease drugs could be reduced by 63% after the operation had been completed.

They concluded that, with Deep Brain Stimulation and by careful patient selection, the dosage of Parkinson's Disease drugs could be significantly reduced with considerable improvements in motor function and quality of life.

RASAGILINE'S EFFECT ON TREMOR IN PARKINSON'S DISEASE

24th June 2013 - New research

The International Journal of Neuroscience [2013] Jun 17 [Epub ahead of print] (M.F.Lew)

Researchers reviewed the effects on tremor in Parkinson's Disease of 1mg daily oral rasagiline, on its own and with other treatments. Tremor is a common symptom of Parkinson's Disease, but it is less responsive to dopaminergic therapy than are the symptoms of bradykinesia and rigidity. Rasagiline is a MAO inhibitor that is marketed as Azilect.  

Of 22 identified publications, 2 large placebo-controlled trials of rasagiline monotherapy (TEMPO and ADAGIO) and 2 large placebo controlled trials of rasagiline with L-dopa (PRESTO and LARGO) specifically evaluated the effect of rasagiline on tremor using the Unified Parkinson's Disease Rating Scale (UPDRS). Analysis of these studies showed rasagiline on its own significantly improved tremor in early Parkinsons' Disease independently of disease duration.

In people taking L-dopa who had motor fluctuations who were already receiving optimal dopaminergic treatment, the addition of rasagiline significantly improved their tremor. Significant improvement was evident as early as ten weeks from the initiation of the use of rasagiline. Tremor symptoms also improved in people with severe tremor when rasagiline was added to their existing Parkinson's Disease treatments. The researchers contend that the data suggest that rasagiline used on its own or alongside other treatments is effective for reducing tremor severity in people with Parkinson's Disease.

Link between allergic rhinitis and Parkinson’s disease

Kriss Moore The Almagest - People who have allergic rhinitis have three times the risk of Parkinson’s disease. Previous research has shown that those taking non-steroidal anti-inflammatory drugs, like ibuprofen, are less likely to develop Parkinson’s disease. So researchers at the Mayo Clinic set out to find out more about a possible link between inflammation and Parkinson’s disease. They studied 196 people who had Parkinson’s disease and compared them with a group of similar age and gender who did not. Those with allergic rhinitis – or hayfever, an inflammatory condition – were 2.9 times more likely to develop Parkinson’s disease. But no similar link was seen for other inflammatory diseases like lupus, rheumatoid arthritis or vitiligo. This may be because there were only small numbers of participants who had these conditions. The researchers say that those with allergic rhinitis exert an immune response to allergens which could affect the brain, leading to Parkinson’s disease. The study does not establish that allergies cause Parkinson’s disease, just that there is an association. Hopefully future research will lead to ways of blocking any inflammation that does cause Parkinson’s disease.