I'm adding to rappleman's and laura's comments on DBS use in the early stages of Parkinson's, and comparing DBS to duodopa.
Check out the duodopa vs. DBS discussion starting at 60:12 in the video "2011 – Research Update: Part 1" located at:
http://www.theparkinsonsgroup.com/pastwebcasts.asp
The consensus among the four MDS specialists/researchers seems to suggest that if they personally had to choose between duodopa and DBS, they would choose duodopa. According to them, both treatments have their complications, but the therapeutic benefits of the two options are comparable and yet the risk of complications, in their opinion, is less in duodopa (in the stomach - peritonitis, etc.) compared to DBS risks (in the brain - stroke, brain infections, etc.).
Based on what I've read and seen (and my opinion I'm sure will evolve and change dozens of times in the years to come as my PD worsens), I too would exhaust all non-invasive options (exercise, supplements, etc.), all pill options AND try duodopa (once FDA approved, or go to Canada!) before I would try DBS.
---------
rappleman: “...what about neurostimulation, both DBS and extradural motor cortex (EMCS). New articles appeared recently suggesting that EMCS is efficacious, safe, little if any downside. If so what if any reasons not to try it? Then on Valentine’s Day the NEJM article on the EARLYSTIM trial. If I read correctly, DBS improves motor symptoms and major secondary outcomes significantly better than medical therapy alone for earlier stage PD, no significant difference in serious adverse events, bottom line in favor for carefully chosen young patients.”
conductor71: “DBS is a last resort; I will go on a drug holiday before I got that route. Be wary of the DBS promotion early on; there is a trend in promoting it in younger patients and many are doing it. It is scary; there is conflicting research on its neuroprotective potential; they cannot even figure out how it works let alone determine it slows progression. Plus, the few studies I have seen were totally biased with authors disclosing ties to Medtronic.”
---------