Less-invasive method of brain stimulation helps patients with Parkinson's disease

Pilot study in Neurosurgery shows safety and benefits of extradural stimulation

2012-10-16

(Press-News.org) Philadelphia, Pa. (October 16, 2012) – Electrical stimulation using extradural electrodes—placed underneath the skull but not implanted in the brain—is a safe approach with meaningful benefits for patients with Parkinson's disease, reports the October issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part ofWolters Kluwer Health.

The technique, called extradural motor cortex stimulation (EMCS), may provide a less-invasive alternative to electrical deep brain stimulation (DBS) for some patients with the movement disorder Parkinson's disease. The study was led by Dr. Beatrice Cioni of Catholic University, Rome.

Study Shows Safety and Effectiveness of Extradural Brain Stimulation
The researchers evaluated EMCS in nine patients with Parkinson's disease. Over the past decade, DBS using electrodes implanted in specific areas within the brain has become an accepted treatment for Parkinson's disease. In the EMCS technique, a relatively simple surgical procedure is performed to place a strip of four electrodes in an "extradural" location—on top of the tough membrane (dura) lining the brain.

The electrodes were placed over a brain area called the motor cortex, which governs voluntary muscle movements. The study was designed to demonstrate the safety of the EMCS approach, and to provide preliminary information on its effectiveness in relieving the various types of movement abnormalities in Parkinson's disease.

The electrode placement procedure and subsequent electrical stimulation were safe, with no surgical complications or other adverse events. In particular, the patients had no changes in intellectual function or behavior and no seizures or other signs of epilepsy.

Extradural stimulation led to small but significant and lasting improvements in control of voluntary movement. After one year, motor symptoms improved by an average of 13 percent on a standard Parkinson's disease rating scale, while the patient was off medications.

'Remarkable' Improvement in Walking and Related Symptoms
The improvement appeared after three to four weeks of electrical stimulation and persisted for a few weeks after stimulation was stopped. In one case where the stimulator was accidentally switched off, it took four weeks before the patient even noticed.

Extradural stimulation was particularly effective in relieving the "axial" symptoms of Parkinson's disease, such as difficulties walking. Patients had significant improvement in walking ability, including fewer problems with "freezing" of gait. The EMCS procedure also reduced tremors and other abnormal movements while improving scores on a quality-of-life questionnaire.

Although DBS is an effective treatment for Parkinson's disease, it's not appropriate for all patients. Some patients have health conditions or old age that would make surgery for electrode placement too risky. Other patients—including four of the nine patients in the new study—are eligible for DBS but don't want to undergo electrode placement surgery.

The concept of extradural stimulation is not new, but previous studies have had important limitations, with inconsistent results. The new report is the largest study of EMCS performed using a standard technique in a well-defined group of patients.

The findings show that extradural stimulation is not only safe for patients with Parkinson's disease, but also effective in improving movement disorder symptoms—with "remarkable effects on axial symptoms," according to Dr. Cioni and colleagues. Although the improvement is not as great as with DBS, the researchers believe that EMCS "should be considered as an alternative option" for at least some groups of patients. Further studies, including long-term follow-up, are underway.

### About Neurosurgery
Neurosurgery, the Official Journal of the Congress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field, Neurosurgery is nothing short of indispensable.

About Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

ELSE PRESS RELEASES FROM THIS DATE:

Stat5 predicts outcomes for prostate cancer patients after radical prostatectomy

2012-10-16

PHILADELPHIA—Men who had high levels of the activated Stat5 protein in their prostate cancer after a radical prostatectomy were more likely to have a recurrence or die from the disease compared to men who had little to no presence of the growth protein, according to a recent study published in Human Pathology by Jefferson's Kimmel Cancer Center researchers. This suggests, Stat5, a protein that when activated signals cancer cells to grow and survive, could be an ideal biomarker to help guide patients and physicians for future treatment. The research team, led by ...

Presidential candidate body language plays little role in voter perception

2012-10-16

Washington, DC (October 16, 2012) Viewer impressions of political candidates are heavily weighted to the content of their speech rather than the body language, a new study published in the Journal of Communication has found. The research, conducted by a trio of German scholars, presents a shift from past research showing that nonverbal communication plays a larger role than verbal in presidential debates. Marcus Maurer (Friedrich-Schiller-Universitaet), Friederike Nagel (Johannes Gutenberg-Universitaet), and CarstenReinemann (Ludwig Maxillians-Universitaet) conducted ...

Eating lots of carbs, sugar may raise risk of cognitive impairment, Mayo Clinic study finds

2012-10-16

ROCHESTER, Minn. -- People 70 and older who eat food high in carbohydrates have nearly four times the risk of developing mild cognitive impairment, and the danger also rises with a diet heavy in sugar, Mayo Clinic researchers have found. Those who consume a lot of protein and fat relative to carbohydrates are less likely to become cognitively impaired, the study found. The findings are published in the Journal of Alzheimer's Disease. The research highlights the importance of a well-rounded diet, says lead author Rosebud Roberts, M.B., Ch.B., a Mayo Clinic epidemiologist. "We ...

Starvation hormone markedly extends mouse life span, UT Southwestern researchers report

2012-10-16

DALLAS – Oct. 15, 2012 – A study by UT Southwestern Medical Center researchers finds that a starvation hormone markedly extends life span in mice without the need for calorie restriction. "Restricting food intake has been shown to extend lifespan in several different kinds of animals. In our study, we found transgenic mice that produced more of the hormone fibroblast growth factor-21 (FGF21) got the benefits of dieting without having to limit their food intake. Male mice that overproduced the hormone had about a 30 percent increase in average life span and female mice ...

Presidential debates say as much about US culture as candidates

2012-10-16

ANN ARBOR—American presidential campaigns provide a unique window into our society, according to a University of Michigan anthropologist. "It says a lot about our culture that we pay so much attention to the clothing, gestures and hair styles of presidential candidates and to their performances in highly theatrical situations, like debates," said Michael Lempert, a linguistic anthropologist at the U-M. Lempert is the co-author with University of Chicago anthropologist Michael Silverstein of "Creatures of Politics: Media, Message, and the American Presidency," just ...

Exercise may lead to better school performance for kids with ADHD

2012-10-16

EAST LANSING, Mich. — A few minutes of exercise can help children with attention deficit hyperactivity disorder perform better academically, according to a new study led by a Michigan State University researcher. The study, published in the current issue of the Journal of Pediatrics, shows for the first time that kids with ADHD can better drown out distractions and focus on a task after a single bout of exercise. Scientists say such "inhibitory control" is the main challenge faced by people with the disorder. "This provides some very early evidence that exercise might ...

Studies report early childhood trauma takes visible toll on brain

2012-10-16

NEW ORLEANS — Trauma in infancy and childhood shapes the brain, learning, and behavior, and fuels changes that can last a lifetime, according to new human and animal research released today. The studies delve into the effects of early physical abuse, socioeconomic status (SES), and maternal treatment. Documenting the impact of early trauma on brain circuitry and volume, the activation of genes, and working memory, researchers suggest it increases the risk of mental disorders, as well as heart disease and stress-related conditions in adulthood. The findings were presented ...

Pitt engineers to design affordable CO2 thickener to augment oil extraction

2012-10-16

PITTSBURGH—Crude oil extraction could be improved significantly and accessible domestic oil reserves could be expanded with an economical CO2 thickener being developed by University of Pittsburgh engineers, thanks to a $1.3 million grant from the U.S. Department of Energy. Current oil-extraction methods across the United States involve oil being "pushed" from underground layers of porous sandstone or limestone reservoirs using a first-water-then-CO2 method known as the water-alternating-gas method. CO2—which is obtained from natural CO2 reservoirs and pipelined to oil ...

A better way to prevent deadly blood clots?

2012-10-16

A computerized checklist system designed to help physicians identify and use the best methods of preventing potentially deadly blood clots in hospitalized trauma patients dramatically reduced the number of these dangerous venous thromboembolisms (VTEs), new Johns Hopkins research suggests. When a doctor enters medical orders for such patients, the automated checklist recommends evidence-based best treatments for each patient's needs, usually the regular administration of low-dose blood thinners or the use of compression devices to keep blood flowing in the legs. The researchers ...

Neuroscientists find the molecular 'when' and 'where' of memory formation

2012-10-16

Neuroscientists from New York University and the University of California, Irvine have isolated the "when" and "where" of molecular activity that occurs in the formation of short-, intermediate-, and long-term memories. Their findings, which appear in the journal the Proceedings of the National Academy of Sciences, offer new insights into the molecular architecture of memory formation and, with it, a better roadmap for developing therapeutic interventions for related afflictions. "Our findings provide a deeper understanding of how memories are created," explained the ...

Less-invasive method of brain stimulation helps patients with Parkinson's disease

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: