Optimization of Parkinson Disease treatment combining anti-Parkinson drugs and deep brain stimulation using patient diaries

The number of patients suffering from Parkinson´s disease is increasing rapidly due to population aging. While traditional medications-based palliative therapy is successful in early stages, deep brain stimulation (DBS) may be used as an alternative treatment in later stages. After DBS implantation, the therapy typically consists of electrical stimulation and reduced medication. In order to provide good clinical outcome, a balance has to be found between medication and stimulation parameters, this is usually done as follows: First, Unified Parkinson´s Disease Rating Scale (UPDRS) scoring is performed, second patients are supposed to fill subjective diaries during a specific period. This study shows that these diaries are useful as therapy progression indicator. Feel scores based on diaries and sleep time were examined with respect to DBS stimulation and medication. The results confirmed the positive effect of both therapy components - stimulation as well as medication - on patient feel scores. Furthermore, a positive correlation was observed between stimulation energy and sleep duration.