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Monday, August 29, 2016

New surgery helps people with Parkinson's disease

Aug. 29, 2016




For people with Parkinson’s, drugs sometimes aren't enough to control tremors and rigid movements, but a change in surgery is opening new doors for some of the patients with the progressive disease. Michael J. Fox, Billy Graham, and the late Muhammad Ali are all well-known public figures who have raised public awareness about Parkinson’s disease.


The progressive movement disorder has no cure, but over the last few years, one new option has made surgery possible for a growing number of patients.
Five years ago Tony Spitzer was diagnosed with Parkinson’s disease.
"It was a tremor. Pretty much the way Michael J. Fox also started. I think he had it in his pinky," said Tony.
His disease progressed, and medication couldn’t stop the tremors. Finally, Tony’s doctor agreed with him that deep brain stimulation, or DBS, would be his next step. With DBS, doctors insert wires to stimulate the portion of the brain impacted by Parkinson’s.

The wires are connected to a battery pack, like a pacemaker. Traditionally, patients had to be awake during the surgery so doctors could ensure they were in the precise spot, and for some, being awake was a deal-breaker.
"I mean I just think … scary as all hell!" said Glenda Spitzer, Tony's wife.

However now, neurosurgeons have another option. Using MRI guidance, they can insert the electrodes in real time while the patient is under anesthesia.
"If there’s any changes in the brain structure, if there’s a little bit of shift in the brain during surgery these are things we actively see," said Dr. Hooman Azmi, a neurosurgeon at the New Jersey Brain and Spine Center.

Soon after Tony’s surgery, both he and his wife noticed the difference. 
"It is amazing. I could see him," said Glenda. "Tony would be tremoring, and then stop."

"It’s controllable. And it makes me feel 100 percent better," said Tony.
Doctor Azmi says the MRI guided procedure is a good option for patients who are too anxious to be awake during the procedure, those who cannot have their medication withheld, and those who would have trouble communicating during surgery.

MRI GUIDED PARKINSON’S SURGERY
REPORT #2337
BACKGROUND: 
Parkinson’s disease is a slowly progressing neurodegenerative brain disorder. Many people live with this disease for years as their symptoms slowly progress. This happens when the brain is not producing enough dopamine. Dopamine is a chemical that sends signals between an area of the brain, called the substantia nigra, and other parts of the brain. These signals control movements of the human body. There are neurons in the human brain that usually produce dopamine. These neurons concentrate in the substantia nigra. When 60 to 80 percent of the cells that produce dopamine are damaged and the brain is not producing enough dopamine the signs of Parkinson’s disease begin to appear. With this disease, the person loses the ability to control their movements, body and emotions. Although the disease itself is not fatal, complications from Parkinson’s are. Complications from this disease is rated the 14th top cause of death in the United States by the Centers for Disease Control and Prevention. 
(Source: http://www.parkinson.org/understanding-parkinsons/what-is-parkinsons) 

TREATMENT: 
With a milder form of Parkinson’s, patients can be prescribed medications to control their symptoms. Possible medications include carbidopa-levodopa (the most effective), carbidopa-levodopa infusion, dopamine agonists, MAO-B inhibitors, catechol-O-methyltransferase (COMT) inhibitors, anticholinergics, or amantadine. If the disease progresses, deep brain stimulation, or DBS, surgery may be the next step. DBS has three components: the lead (or electrode), the extension and the neurostimulator (or the “battery pack”). During DBS the surgeon will implant the electrodes into a specific part of the brain. Then a generator, or neurostimulator, is implanted in your chest near your collarbone and is connected to the electrodes. This generator sends electrical pulses to your brain and hopefully reduces the symptoms from Parkinson’s. The settings can be adjusted on the generator to suit your specific needs based on your progression. The surgery may provide life-changing relief from symptoms, but it does not stop the disease from progressing. 

(Source: http://www.mayoclinic.org/diseases-conditions/parkinsons-disease/basics/treatment/con-20028488, http://www.parkinson.org/understanding-parkinsons/treatment/surgery-treatment-options/Deep-Brain-Stimulation) 

NEW TECHNOLOGY: 
Traditionally, patients had to be awake during the DBS surgery, but now surgeons can use guidance from an MRI to insert the electrodes. In other words, the patient may be under anesthesia during the procedure. The MRI gives the surgeon an exact location to place the electrodes. Tony’s wife, Glenda Spitzer said, “As soon as the pulse generator (battery) was turned on we saw a difference.”

(Sources: http://www.parkinson.org/understanding-parkinsons/treatment/surgery-treatment-options/Deep-Brain-Stimulation) 
? For More Information, Contact:
Mara Quigley
mara@steveallenmedia.com 
661-255-8283

Watch Video:

http://www.wndu.com/content/news/New-surgery-helps-people-with-Parkinsons-disease--391650001.html

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