Treatment for Parkinson's shows promise

hysicians at Strong Memorial Hospital will soon begin offering a revolutionary treatment for Parkinson's, recently approved by the FDA, that may effectively improve motor function during the advanced stages of the disease.

"Deep brain stimulation" therapy involves implanting an electrode device in precisely targeted areas of the brain to deliver carefully controlled pulses of electrical stimulation to relieve the debilitating slowness, stiffness, and shaking that characterize Parkinson's. The electrodes are connected by wires under the skin to a pulse generator--similar to a pacemaker--implanted under the collarbone.

Robert Bakos, associate professor of neurosurgery, says that the surgery is unique because the patient is awake to help guide the placement of the electrodes. "We use computers to pinpoint the specific area on the brain for placement of the electrodes, but then we work with the patient during the surgery to find the precise area that is the major source of Parkinson's disease symptoms," says Bakos. "We then ask the patient to hold a coffee cup or write on a pad as we fine-tune the electric impulse."

According to Timothy Counihan, assistant professor of neurology and codirector of the Strong Surgical Treatment Program for Movement Disorders, patients in clinical trials using the electronic implants have shown up to a 60 percent improvement in motor function three years following the surgery, despite a substantial reduction in their medication usage and progression of the disease.

"From my perspective, this is the single biggest advancement in treatment for Parkinson's in the last decade," says Counihan. "For most patients, medication eventually becomes ineffective as the disease progresses, leaving the person with no real treatment alternatives but a slow, inexorable deterioration. This new procedure provides a marked improvement in motor function, allowing many patients to achieve a better quality of life."

About 15,000 people worldwide have been implanted with the devices in Europe, Canada, and Australia since 1995. Doctors at Strong have a waiting list of 20 people eligible for the surgery.

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