Brain Pacemaker Helps Parkinson's, but With Risks

After six months, patients visited neurologists who did not know whether they had had surgery or medication. In the surgery group, 86 out of 121 (71 percent) saw meaningful improvements in movement, as scored by the neurologists. In the medication group, 43 out of 134 patients (32 percent) showed meaningful improvements.

Sharon Pederson poses for a photograph at a friend's house in Petaluma, Calif., Monday, Jan. 5,...

Sharon Pederson poses for a photograph at a friend's house in Petaluma, Calif., Monday, Jan. 5, 2009. Pederson is a study subject who got deep brain stimulation, or DBS, surgery for her Parkinson's disease. In DBS, a surgeon implants electrodes in the brain which are then connected to a pacemaker-like device that can be adjusted and turned off and on. The device sends tiny electrical pulses to the brain, disabling overactive nerve cells. (AP Photo/Jeff Chiu)

(AP)

In the surgery group, 49 had serious problems, including infections, falls and one death because of complications from the surgery. In the control group, only 15 people encountered serious problems.

Another way to measure gains for Parkinson's patients is the amount of "on" time — good quality movement time. Recording these times during the day in diaries, patients who had surgery gained, on average, nearly five hours of "on" time each day. Patients who didn't have surgery made no gains in that area.

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"It's really brought a lot of freedom back to my life," said surgery patient Sharon Pederson, 51, of Tomales, Calif. She said medication worked well for four or five years but started causing her arms to fling out wildly.

"I would go to brush my hair and the brush would fly across the room," she said. "Once I was eating a yogurt while I was in the car. I came inside and said, `I had a fight with a container of yogurt.' It was all over the inside of the car."

Surgery not only stopped the flailing but halted an intense sensation that her nerve endings were burning. Her depression also disappeared. The ability to write her normal flowing signature came back, too.

It didn't work for everyone. A few surgery patients (about 3 percent) got worse.

"You don't want to underestimate or overestimate the risks," said Weaver, a specialist in chronic care. "It still is an individual decision between a patient and a physician."

Surgery to implant the electrodes and pacemaker costs about $60,000 and is covered by Medicare and some insurance companies. Medications can cost $5,000 a year. After surgery, patients were able to cut their medications by 23 percent on average.