Parkinson's disease is a disorder that affects nerve cells, or neurons, in a part of the brain that controls muscle movement.
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Researchers at Duke University report in the journal Science that a pacemaker-like device that stimulates the spinal cord helps rodents with a condition resembling Parkinson’s disease resume normal movement. The study is the first to show that symptoms of Parkinson’s disease can be helped by stimulating a site outside of the brain. If the device proves to work in humans it could help thousands who suffer with the brain disorder that causes tremors, rigidity, and difficulty initiating movement.
Parkinson’s disease occurs when a group of brain cells that produce the chemical messenger dopamine die. Without these cells as a source of dopamine, it becomes more and more difficult for people to initiate movement. Existing drug treatments such as L-DOPA focus on replacing lost dopamine, but these drugs lose their potency over time. Deep brain stimulation, in which electrodes are implanted deep into the brain to stimulate it, can be an effective treatment, but it requires highly invasive brain surgery and may only have the potential to help about one-third of patients.
In the present study, the researchers developed a prosthetic device that applies electrical stimulation to the dorsal (rear) portion of the spinal cord, which carries sensory information from the body to the brain. They implanted the devices into mice and rats that had depleted levels of the brain chemical dopamine, causing them to have movement problems very similar to people with Parkinson's disease. When the researchers turned on the device, the animals’ symptoms improved dramatically in an average of under 3.5 seconds.
The researchers also found that spinal cord stimulation helped lower the dose of Parkinson’s medications needed to improve the animal’s symptoms.
A spinal stimulating device could potentially help many more Parkinson’s patients thandeep brain stimulation because it is far easier to implant. In addition to improving patients’ symptoms directly, the device may reduce the amount of medication patients need, thereby extending the amount of time they are able to take it.
The researchers plan to begin testing the device in primates this year, and hope to begin human trials in 2010.
For more information on Parkinson’s Disease treatments, join theHealia Support Group for Parkinson’s Disease. Have a question about Parkinson’s? Ask the Experts a question on Healia Communities.
Photo: Ed Yourdon, Flickr, Creative Commons
A study released this week in the Journal of the American Medical
Association finds that a technique called deep brain stimulation can offer new
hope to people suffering with Parkinson’s Disease, an incurable brain disease
that disrupts movement. In the largest study yet of deep brain stimulation,
patients who received the treatment showed dramatic improvements in their
movements compared to patients taking drugs, the standard Parkinson’s
treatment.
The study, which followed about 250 Parkinson’s patients for six months, showed that for 71 percent of patients, deep brain stimulation reduced tremors, lessened rigidity, and gave patients an extra four and a half hours of good motor functioning each day. Their quality of life and emotional well-being also improved.
However, the study also found that deep brain stimulation is not without risks. The highly invasive technique, approved by the Food and Drug Administration in 2002 for advanced Parkinson's disease, involves implanting electrodes deep within the brain and connecting them to an electrical device implanted in the abdomen or chest. The device then produces a small current that flows through the electrodes and into the brain at regular intervals, kind of like a “brain pacemaker.” This current disables overactive brain cells that inhibit movement and cause tremors.
Parkinson’s disease occurs when, for unknown reasons, cells in a small part of the brain called the substantia nigra die. These cells normally release the neurotransmitter dopamine, which helps the body produce smooth movements. Parkinson’s patients face an inevitable decline in their ability to move, but symptoms can be improved by the use of drugs that help the brain produce more dopamine. Unfortunately, these drugs often lose their effectiveness over time, leaving patients desperate to find a new approach.
About 40 percent of the patients who received the implants suffered serious side effects, including infections, falls, and one patient who died of a ruptured blood vessel subsequent to the surgery. The falls may have been due to improved movement ability, as patients tried to do activities they may not have performed in years – one man fell off his roof while attempting repairs. A few surgery patients (about 3 percent) actually got worse.
While deep brain stimulation appears to improve movement for many patients, it does not cure the disease or prevent it from worsening over time. It also does not improve non-motor symptoms that often occur with Parkinson’s including problems with thinking, memory, or speech. Also, it is unclear if deep brain stimulation continues to benefit patients indefinitely or whether it, like Parkinson’s drugs, will lose its effectiveness over time.
Not everyone is a good candidate for the deep brain stimulation, but if you or a loved one has advanced Parkinson’s disease, talk to a healthcare professional to find out if the treatment is appropriate. The implantation procedure costs around $60,000 but it is covered by Medicare and also by some insurance companies.
For more information on Parkinson’s disease, join the Healia Health
Community on Parkinson’s disease.
Photo: borya, Flickr, Creative Commons
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