By Jana Soeldner Danger
Parkinson’s disease turns life into a daily challenge. The degenerative disorder causes tremors, muscle rigidity and slowness of movement. Medications can often control symptoms, but as the disease progresses, they may become ineffective.
A procedure called deep brain stimulation can often provide relief. The technique has been used since the1990s, but new technology has made it safer and more effective, says Dr. Robert Levy, director of the Marcus Neuroscience Institute at Boca Raton Regional Hospital. Recent studies have also shown that the procedure can be effective in treating other conditions, such as obsessive-compulsive disorder, severe depression, essential tremor, and chronic pain.
“Computerized robotics and state-of-the-art imaging can better identify the areas of the brain involved in these disorders,” Levy says. “Very high-quality imaging allows us to plan the trajectory so that it is much safer than in the past.”
Here’s how it’s done: A medical team implants electrodes into the patient’s brain, where they produce electrical impulses. These impulses are controlled by a battery pack similar to a pacemaker, which is inserted under the skin on the patient’s chest. A permanent wire also implanted under the skin connects the device to the electrodes in the brain, where the impulses they generate creates change in specifically targeted areas.
Parkinson’s results when nerve cells that produce a chemical called dopamine, a neurotransmitter that signals the brain to produce movements, are damaged or die. Impulses from the implanted electrodes do some of the work that the missing dopamine is supposed to do.
During the procedure, the physician makes a dime-sized incision into the head of a fully conscious patient and advances a wire through the brain. In addition to visual imaging, the medical team uses audio cues to pinpoint the target, “A microelectrode recording device allows us to listen to the electrical signatures of the cells as we pass the target,” Levy says. “We hear a series of popping and buzzing sounds that reflect the patterns and activities that characterize different layers of the brain.”
A small amount of electrical current is applied as a test to see if the patient’s arm stops shaking. If it does, the physician knows the target area has been reached and completes the procedure.