In the 1990s, Professor Alem-Louis Benapade, a neurosurgeon in Grenoble (Isère), discovered that deep brain stimulation of a region of the brain, the hypothalamic nucleus, has a significant therapeutic effect against the symptoms of Parkinson’s disease. Since then, more than 100,000 patients have been treated in this way all over the world, with significant improvement in their agitation, tremors, rigidity, and slowness of movement.
This technique consists of placing electrodes in the brain during an invasive procedure under anesthesia to permanently stimulate neurons of the subgenually sedated nucleus with a weak electric current. The electrodes are attached to a box containing a battery implanted under the skin.
The treatment can not be applied to all patients, but mainly to young people who are in good health. Every year in France, between 400 and 500 people benefit from it. Long-term studies have shown that the effect of treatment on movement disorders lasts for at least ten years for most patients.
An effective, but cumbersome and expensive therapeutic strategy
The great difficulty lies in the selection of patients who will benefit from this therapeutic strategy, which is effective but cumbersome and expensive to implement. The PREDI-STIM study, coordinated by Professors David Devos (CHU de Lille) and Jean-Christophe Corvol (CHU Pitié-Salpêtrière), aimed to predict response to deep brain stimulation of the hypothalamic nucleus based on improvement in quality of life of patients one year after the intervention and what after him. The results will make it possible to propose new selection criteria for patients who are candidates for this intervention.
To date, 617 patients in 17 French specialized centers were included in this study. Besides the clinical data, the researchers monitor other criteria, related to imaging, biological and genetic markers, in patients who are candidates for surgery, to better predict their future after the intervention. This work also shows that sleep disorders are not a factor in poor prognosis. Thirty studies are ongoing in this group of patients.
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