Parkinson's Disease Treatment
One of the most demoralizing aspects of Parkinson's disease is how completely a person's world changes. The most basic daily routines may be affected -- from socializing with friends and enjoying normal and congenial relationships with family members, to earning a living and taking care of a home. Faced with a very different life, people need encouragement to remain as active and involved as possible. That's when support groups can be a valuable part of Parkinson's disease treatment, not only to the person affected, but to their families and caregivers as well.
Surgery as a Part of TreatmentSurgery for Parkinson's disease was once a common practice. However, after the discovery of levodopa, surgery was restricted to only a few cases. Currently, surgery is reserved for people who have failed to respond satisfactorily to drugs.
One of the procedures used as part of Parkinson's disease treatment, called cryothalamotomy, requires a supercooled metal probe tip to be surgically inserted into the thalamus (a "relay station" deep in the brain). This destroys the area of the brain that produces tremors. This and related procedures, such as thalamic stimulation, are coming back into favor for people who have severe tremors or have Parkinson's only on one side of the body.
Parkinson's disease research scientists have also revived interest in a surgical procedure called pallidotomy, in which a portion of the brain called the globus pallidus is purposely damaged. Some studies indicate that pallidotomy may improve symptoms of tremors, rigidity, and bradykinesia, possibly by interrupting the neural pathway between the globus pallidus and the striatum or thalamus. Further research on the value of surgically destroying these brain areas is currently being conducted.
Restorative surgery, using nerve cell transplants to supplement a person's own dopamine-producing nerve cells, is also under investigation.
A therapy called deep brain stimulation (DBS) has now been approved by the U.S. Food and Drug Administration (FDA) for treating Parkinson's disease. In DBS, electrodes are implanted into the brain and connected to a small electrical device, called a pulse generator, that can be externally programmed. DBS can reduce the need for levodopa and related drugs, which, in turn, decreases the involuntary movements (dyskinesias) that are a common side effect of levodopa. It also helps to:
- Alleviate fluctuations of symptoms
- Reduce tremors, slowness of movements, and gait problems.
DBS requires careful programming of the stimulator device in order to work correctly (see Deep Brain Stimulation for Parkinson's).