Archive for the ‘Parkinson’s Disease’ Category

PARKINSON’S DISEASE: WHEN IS DEEP BRAIN STIMULATION APPROPRIATE

Tuesday, October 19th, 2010

According to the National Institute of Neurological Disorders and Stroke, about 500,000 people in the U.S. have been diagnosed with Parkinson’s disease. Another 50,000 new cases are expected this year alone.  Parkinson’s is a degenerative disease process of the central nervous system, which affects a person’s motor function and speech. In essence, the disease leads to a degeneration of the neurons that control movement.

Symptoms of Parkinson’s disease include: uncontrolled tremors or shaking of the limbs, slow movement or inability to move, rigidity of the extremities, abnormal gait, lack of facial expressions, dementia, sleep disorders, sexual dysfunction and speech impairments.  Notable individuals that have been diagnosed with Parkinson’s disease include: Muhammad Ali, Salvador Dali, Michael J Fox, Janet Reno, and Pope John Paul II, among many others.

Despite the fact that thousands of people suffer from this disease, there is very little information about how to effectively treat it. For example, for some time now, it has been unclear if and when deep brain stimulation should be used on patients with Parkinson’s disease.  Deep brain stimulation is a surgical procedure, whereby a brain implant (one that operates similar to a pacemaker) is placed into the brain.  The implant sends electrical impulses to various parts of the brain, sometimes leading to noticeable improvements in motor function.

Although the FDA approved this surgical procedure in 2002, there was no consensus in the medical community on when this surgery should be performed.  Well, this changed about a week ago. According to a report published in the Archives of Neurology, about 50 of the nation’s leading experts on the use of deep brains stimulation have reached general agreement on when this surgical procedure should be considered.

According to this report, deep brain stimulation should be considered for those patients “who can’t tolerate the side effects of medication and those who don’t suffer from significant active cognitive or psychiatric problems but who do suffer from tremors or motor skills control.” The report further notes:

  • Deep brain stimulation surgery is best performed by an experienced team and neurosurgeon who have expertise in stereotactic neurosurgery — microsurgery deep within the brain that is based on a three-dimensional coordinate system using advanced neuroimaging.
  • Deep brain stimulation is effective when used in the two most commonly treated areas of the brain, called the subthalamic nuclei and the globus pallidus pars interna. But treatment in the subthalamic nuclei may cause increased depression and other symptoms in some patients.
  • Surgical removal of the area of the brain that causes Parkinson’s disease is an effective alternative and should be considered as an alternative in some people.
  • Surgical complication rates vary, with infection being the mostly commonly reported side effect of deep brain stimulation.

If you have been diagnosed with Parkinson’s disease, take a moment to read the report and ask your doctor about a treatment course that best fits the characteristics of your disease.