While stimulating the subthalamic nucleus (STN) generally has been the therapy of choice, new research published in the June 20, 2012, issue of Neurology®, the medical journal of the American Academy of Neurology, challenges that preferred status, finding that stimulating the internal globus pallidus (GPi) may provide some long-term advantages.
The subthalamic nucleus has been regarded as the preferred target since 2002, when the Food and Drug Administration approved the therapy for Parkinson’s disease. Many physicians made this therapeutic choice because stimulation of the subthalamic nucleus often enabled patients to reduce their drugs, such as levodopa; the choice of target was left to doctors because no major clinical trial had shown that one target provides better results than the other.
The largest randomized trial, published in 2010, found “motor” outcomes – movement control – fared equally, regardless of target. That study and others also showed that while stimulation can improve motor skills, it does not stop cognitive, mood or behavioral declines.
The new study, based on outcomes in 159 patients from the 2010 trial, challenges the preferred targeting, finding that stimulating the internal globus pallidus may provide long-term advantages in both motor skills and cognitive function.
In his editorial, Tagliati says these and other findings warrant more research to answer questions such as: “Is it important or even desirable to reduce medications over the long term? Do medication and stimulation have a complementary or alternative role? Is GPi stimulation more compatible with long-term medical therapy? Is chronic STN stimulation interfering with dopaminergic stimulation?”
“If the art of making medical decisions reflects a continuous struggle between evidence- and preference-based practices, this study will inject more reliable evidence in delicate long-term decisions, based until now almost exclusively on the preference and personal experience of the DBS provider,” he concludes.
Citation: Neurology: “Turning Tables: Should GPi become the preferred DBS target for Parkinson’s Disease?” (editorial), published online at 4 p.m. Eastern time June 20, 2012, in print July 3, 2012.Media Contact: Sandy Van
Sandy Van | Cedars-Sinai News
Millions through license revenues
27.04.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn
New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM
More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.
Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...
Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.
"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...
The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.
Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...
The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...
Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.
Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...
28.04.2017 | Event News
20.04.2017 | Event News
18.04.2017 | Event News
28.04.2017 | Medical Engineering
28.04.2017 | Earth Sciences
28.04.2017 | Life Sciences