Medications have long been in use for Parkinson’s disease. Use of different medications has resulted in the betterment of the life of the patient with the disease. All the symptoms of the Parkinson’s disease like tremors, bradykinesia, and rigidity are controlled to some extent for some period of time by the medications available.

But after a period of time, medications become ineffective to control the progression of the disease. The symptoms worsen. Then other modalities of treatment are considered. Surgical treatment is one option. A new mode of treatment which has come up for the treatment is deep brain stimulation.

What is deep brain stimulation?

Deep brain stimulation is a surgical procedure for the treatment of Parkinson’s disease. It involves placing a small electrode within the brain surgically. The area of the brain for the electrode insertion is chosen carefully. The area in the brain with the maximum amount of active cells of Parkinson’s disease is chosen for the procedure. The electrode is connected to a pulse generator and gives intermittent electric stimulus to the cells. The stimulus would control the excessive brain activity in the area and in effect control the symptoms of the disease.

Is the procedure helpful?

Deep brain stimulation is an advanced procedure and is commonly seen to control the symptoms of the disease. The use of the oral medication in the patients is reduced after the surgery. It also reduces the dyskinesias which are often associated with levodopa use. In several patients of Parkinson’s disease, it is seen that the as the disease progresses, patients experience a fluctuation of the symptoms. With the progression of the disease, the patient experience a time when the amount of the medication becomes inadequate to control the symptoms. When deep brain stimulation is done, the patient experiences a medication like state even when off medication.

Are there risks involved with the surgery?

As any surgery, there are risks involved with deep brain stimulation as well. Bleeding may occur in some patients and might turn fatal. In some patients, stroke also occurred post operatively. Infection also may occur in some patients, but with advanced modern medicine, it is easily controlled.

The outcome of the procedure depends on the patient’s condition at the time of the surgery. The presentation of the Parkinson’s disease itself varies in every individual patient; hence the effect of the treatment also may be different for different patients.

There are several medications available for the treatment of Parkinson’s disease. Levodopa is the most common medication used for a patient with Parkinson’s disease. Levodopa is given to the patients with the intention of reducing the symptoms of the disease such as stiffness, tremor and slowing of the movements. But since the medication is taken orally, very little amount of it reaches the brain. The mechanism of action of levodopa is stimulating the brain cells to convert it into dopamine. Advances in modern technology discovered other medications when given along with levodopa, allows slow release of the medication and hence an optimal amount of the drug to reach the brain.

Anticholenergics are used along with levodopa. Amantadine may also be used along with levodopa and helps in the reduction of fatigue, tremor and bradykinesia.

Neuroprotective treatments aid in the protection of the brain cells and is seen to be helpful in the patients with early stages of Parkinson’s disease. Selegiline is a drug which inhibits the enzyme monoamine oxidase B. the enzyme breaks down the dopamine in the brain and reduces the time dopamine is available in the brain. Inhibition of this enzyme would increase the time when dopamine is available in the brain and thereby reduces the progression of the disease.

There are surgical treatments also available for Parkinson’s disease. They come into the picture at a very later stage in the progression of the disease. In the earlier stages of the disease, it is attempted to delay the progression, then the symptoms are reduced with the aid of medications, but at a later stage when the patient starts experiencing wearing off, of the medication, surgery may provide some relief.

Pallidotomy and is an ablative procedures where a small area in the brain, which produces the symptoms of Parkinson’s disease, is destroyed surgically. This would immediately reduce the symptoms of the disease.

Deep brain stimulation procedures are also conducted in an effort to reduce the symptoms of Parkinson’s disease. In this procedure, an electrode is placed within the brain and intermittent stimulation of the abnormal cells which result in the symptoms of Parkinson’s disease is done. It is aimed at restricting the activity of these abnormal cells.

With all these treatment modalities, the quality of life of the patient of Parkinson’s disease might be improved.