Deep Brain Stimulation Can Help Parkinson's Disease

Parkinson’s Disease
Having been amongst seniors for many decades now, I have been able to observe and learn from the way they handled new and challenging health issues. I have been inspired by their courage and persistence. As an editorialist, I have championed the cause of getting all Americans Universal Health Care. If we can spend trillions of dollars on war and the greed of capitalism, we certainly can afford to address the needs of our citizens for a comprehensive health care system. We are the military might of the world and ranked 45th in longevity by the World Health Organization.
They say that one man can’t do much to bring about positive results in this government. Governor Howard Dean sent me a letter of recognition for my continued advocacy demanding Universal Health Care with more emphasis on prevention and a JFK approach to curing Cancer that would equal our commitment to put a man on the moon.
Now IS the time for Americans to get their tax dollar's worth in a positive way. They say that Canadians don’t like their system. Well, we are not Canada, but we do have over 45 million Americans without the resources to buy or obtain health care for them and their loved ones.
In the 90s I suggested to my stock broker that cures would not come from pills. The body begins to ignore the initial reaction to pills and eventually their effect wears off as it did in "Awakening" starring Robin Williams and Robert DeNiro.
The Mount Sinai School of Medicine has just released information (April 2009) on "Deep Brain Stimulation" and they claim that it can help Parkinson’s Disease.
For Parkinson’s disease patients, medications sometimes relieve symptoms such as tremors, rigidity, and impaired coordination. However, as the disease progresses, the medications often become ineffective, resulting in severe functional limitations and disability. For these patients, a surgical treatment called deep brain stimulation (DBS) may be the answer.
"The most important benefit of DBS is the consistency and predictability it provides," says Michele Tagliati, MD, director of the Parkinson’s Disease Center and an associate professor of neurology at Mount Sinai School of Medicine. "In advanced Parkinson’s patients, the response to medications becomes unpredictable and bizarre," he explains. "DBS can give them back their quality of life."
How DBS works. Parkinson’s disease damages or kills nerve cells in the brain which produce dopamine, a chemical responsible for coordinated muscle movements. With DBS, an electrode is surgically implanted into the brain and then connected via a wire to a neurostimulator implanted under the skin near the collarbone. The neurostimulator acts much like a pacemaker, sending electrical impulses to the electrode and stimulating production of dopamine.
A common measure of Parkinson’s patient’s functional ability is called "time on"—the amount of time per day the patient is able to engage in activities of daily living such as walking, speaking, and dressing.
"With DBS, the average ‘time on’ for patients goes from two to three hours per day up to nine to 10 hours per day." says Dr. Tagliati. He explains that after the surgery, the majority of patients still take medications, but many are able to take less which reduces side effects as well as cost. Some patients continue to take the same number and dosage of medications but experience fewer complications. And about 5 percent have such good results they are able to stop taking medications altogether.
Best candidates for DBS. According to Dr. Tagliati, a patient is a good candidate for DBS if they have advanced idiopathic Parkinson’s (the classic type of the disease rather than Parkinson’s that results from events such as head trauma or drug toxicity), with severe symptoms that cannot be controlled by medications. They must be, or have been, responsive to the medication levodopa, and the must be free of cognitive decline or dementia, since brain surgery can aggravate these conditions.
Risks of DBS. DBS carries many of the same risks as any other surgery, including risk of infection and pain at the surgical sites. "During the surgery itself, the biggest risk is of hemorrhage and clotting, which can occur if the wire inserting the electrode nicks a vein," explains Dr. Tagliati. The incidence of hemorrhage during surgery is about one percent. Other risks are related to the malfunctions that can occur in the implanted devices. Dr. Tagliati estimates that there is a 10 to 20 percent risk of hardware-related problems but adds that these risks are not life-threatening. A third possibility is that the electrical stimulus can cause pain, double vision, or speech disturbances. In these cases, the electrode must be repositioned.
"Each patient must weigh, with their doctor, the risks against the benefits, depending on their level of disability," says Dr. Tagliati. "A patient who has become virtually immobilized by Parkinson’s is usually willing to take the surgery risks to get his or her life back."
WHAT YOU CAN DO
To slow progression and/or reduce symptom severity of Parkinson’s:
Get regular exercise, which Dr. Tagliati calls "the number one tool that results in slower progression of Parkinson’s."
Don’t take your medications at the same time you’re eating protein, as protein can interfere with the absorption of Parkinson’s drugs.
Get a good night’s sleep, as fatigue can worsen symptoms.