Intrepidly studying deep brain stimulation in patients with Parkinson's disease

摘要

The subthalamic nucleus has become the preferred target for deep brain stimulation (DBS) in the treatment of patients with advanced Parkinson's disease. Five randomised controlled trials comparing DBS of the subthalamic nucleus with best medical treatment and numerous uncontrolled studies have shown a significant effect of DBS on motor complications associated with levodopa treatment. Nevertheless, there are many open questions, particularly related to its effect size versus the contribution of placebo effects. In The Lancet Neurology, Jerrold L Vitek and colleagues report the results of a randomised, double-blind, sham-controlled study (INTREPID) involving 23 centers in the USA, that assessed the efficacy of DBS of the subthalamic nucleus by use of a novel multiple independent contact current-controlled (MICC) device in patients with Parkinson's disease. Findings are based on a prespecified interim analysis of the first 160 operated patients, of whom 121 received active stimulation and 39 were in the control group with sham stimulation.