While the results in this patient, who was treated by a reputable DBS team, are interesting, I would caution the public not to make too much of this one case. First, it is widely known that performing standard STN DBS surgery on PD patients with even early dementia can severely worsen their cognitive condition. One would expect that inserting four DBS electrodes (rather than the standard two) through the frontal lobes will increase that risk further and that such complications will arise if more of these procedures are performed. Second, the NBM is a thin ribbon of tissue and the electrical field created with the stimulation parameters employed extended well beyond this area. Moreover, the authors provided neither microelectrode recording data nor a post-operative MRI to prove that the electrodes were within the NBM. Third, between weeks 25 and 29, as shown in Figure 2, there is a downward trend in all of their cognitive measures. Finally, I would view with great skepticism any claims that stimulation is neuroprotective, especially based on results in one patient. A...  Read more

While the results in this patient, who was treated by a reputable DBS team, are interesting, I would caution the public not to make too much of this one case. First, it is widely known that performing standard STN DBS surgery on PD patients with even early dementia can severely worsen their cognitive condition. One would expect that inserting four DBS electrodes (rather than the standard two) through the frontal lobes will increase that risk further and that such complications will arise if more of these procedures are performed. Second, the NBM is a thin ribbon of tissue and the electrical field created with the stimulation parameters employed extended well beyond this area. Moreover, the authors provided neither microelectrode recording data nor a post-operative MRI to prove that the electrodes were within the NBM. Third, between weeks 25 and 29, as shown in Figure 2, there is a downward trend in all of their cognitive measures. Finally, I would view with great skepticism any claims that stimulation is neuroprotective, especially based on results in one patient. A neuroprotective role for DBS has been proposed in the past but has never been proven.

View all comments by Ron Alterman

I had bilateral DBS in Aug 2009, and I was so amazed at the impact it had on improving my quality of life. For the first time in more than 10 years I could sign my name, and eat without dropping things. While I agree it is not a total cure, the reality is it gave me more than 80 percent motor control. I hope more information is made available so people can make a timely decision.

View all comments by EDWIN YAGER