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Neurostimulation for Parkinson's Disease with Early Motor Complications

Subthalamic stimulation reduces motor disability and improves quality of life in patients with advanced Parkinson's disease who have severe levodopa-induced motor complications. It was hypothesized that neurostimulation plus medical therapy would be beneficial at an earlier stage of Parkinson's disease than medical therapy alone.

In this trial, the primary endpoint, the quality of life, for the neurostimulation plus medical therapy group improved significantly in comparison with medical therapy alone. Neurostimulation was superior to medical therapy with respect to motor disability activities of daily living, levodopa-induced motor complications , and time with good mobility and no dyskinesia. The levodopa-equivalent daily dose was reduced by 39% in the neurostimulation group but was increased by 21% in the medical-therapy group, Suicidal ideation and suicide attempts were of similar frequency in the two groups, but depression was more frequent in the neurostimulation group. Adverse events related to surgery or the implanted device also manifested, but all but 1 resolved completely.

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