title: Deep brain stimulation for early-stage Parkinson's disease: an illustrative case.
abstract: OBJECTIVE
  Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective intervention in advanced Parkinson's disease (PD), but its efficacy and safety in early PD are unknown. We are conducting a randomized pilot trial investigating DBS in early PD. This report describes one participant who received bilateral STN-DBS.
  
  
  METHODS
  Thirty subjects have been randomized to either optimal drug therapy (ODT) or DBS + ODT. Microelectrode recordings from the STN and substantia nigra are collected at implantation. The Unified Parkinson's Disease Rating Scale Motor Subscale (UPDRS-III) is administered in the ON and OFF states semi-annually and neuropsychological function and quality of life are assessed annually. We describe a 54-year-old man with a two-year history of PD who was randomized to DBS + ODT and followed for two years.
  
  
  RESULTS
  The subject showed a lower STN to substantia nigra ratio of neuronal activity than advanced PD patients, and higher firing rate than non-PD patients. The subject's total UPDRS and UPDRS-III scores improved during the two-year follow-up, while his OFF UPDRS-III score and levodopa equivalent daily dose increased. Quality of life, verbal fluency, and verbal learning improved. He did not experience any serious adverse events.
  
  
  CONCLUSIONS
  This report details the first successful application of bilateral STN-DBS for early-stage PD during a clinical trial.
authors.affiliation: Stritch School of Medicine, Loyola University, Maywood, IL, USA.
authors.forename: Chandler E
authors.initials: CE
authors.lastname: Gill
authors.forename: Laura A
authors.initials: LA
authors.lastname: Allen
authors.forename: Peter E
authors.initials: PE
authors.lastname: Konrad
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Davis
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Bliton
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Finder
authors.forename: Michael G
authors.initials: MG
authors.lastname: Tramontana
authors.forename: C Chris
authors.initials: CC
authors.lastname: Kao
authors.forename: Michael S
authors.initials: MS
authors.lastname: Remple
authors.forename: Courtney H
authors.initials: CH
authors.lastname: Bradenham
authors.forename: P David
authors.initials: PD
authors.lastname: Charles
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D010865:Pilot Projects