Parkinson s Disease and Deep Brain Stimulation

Dr Raghuram G, Consultant Neurosurgeon, Columbia Asia Hospitals explains the improved treatment options for Parkinson's and movement disorders

How has Deep Brain Stimulation improved treatment of Parkinson’s disease and other movement disorders?
There has been a constant need for improving in the quality of life in patients with Parkinson’s and other movement disorder patients. In addition to newer drugs, surgical treatment has been a major step in this regard.

Deep Brain Stimulation surgeries as well as Lesioning surgeries have contributed significantly in improving patients’ quality of life. The last decade has seen significant improvement in the techniques as well as the safety of these procedures. Neuro-navigation techniques with advanced software and higher resolution MRI images have helped in more precise targeting and reducing the side effects.

What are the minimally invasive surgical options available today?
Deep brain stimulation (DBS) uses a surgically implanted, battery-operated neuro-stimulator to deliver electrical stimulation to targeted areas in the brain that control movement. DBS surgeries are done through a small hole drilled in the head. These are high precision surgeries guided by latest neuro-navigation techniques. The patient is awake during the surgery so as to assess the response in the operation theatre. 

How does Deep Brain Stimulation work?
The Neurons in the brain work through electrical transmission of information facilitated by neurochemicals. The current in the circuitry, which is disturbed in patients with Parkinson’s disease, is modified by Deep Brain Stimulation. This process also allows the inhibition of excessive electrical activity and altering erratic activity.

How does it help?
The motor fluctuations - on and off periods - are reduced and through the day patient is able to do all routine activities. Tremors and stiffness in hands and legs also come down after the procedure. The medicines are reduced after the stimulation is started and this significantly reduces the side effects of the medicines such as abnormal posturing of the limbs, neck and hallucinations.

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