Deep brain stimulation: Cutting edge treatment for Parkinson’s - October 23, 2013
Courtesy of the Times
Before his deep brain stimulation procedure, Parkinson’s disease patient Frank Maver could not drive his car or get out of a chair without assistance. After the procedure he says, “my life has improved so much it’s unbelievable.”
The deep brain stimulation, commonly compared to a pacemaker for the brain, and DaTscan, an imaging technique used to track dopamine in the brain, are two technologies local hospitals are using to benefit Parkinson’s patients.
“It’s been hugely successful,” says Andrea DeLeo, a neurologist at Northwest Indiana Neurologic Associates and on staff at Community and St. Catherine hospitals.
“The main focus is to give patients back the quality of life that they have been missing and it really has been able to do that. Patients are driving again, able to go shopping, bathe themselves, feed themselves, many different things. It’s also improved the quality of their (family) relationships by the fact that they are not needing as much help.”
Maver, who had the deep brain stimulation done this spring, is a 77-year-old Highland resident. About six years ago, he had trouble with one of his fingers while trying to cut meat. It got progressively worse, he says, and his Parkinson’s had progressed to stage 3 by the time he decided to try the deep brain stimulation therapy.
“It took me about a year or more to decide if I wanted somebody to fish in my head, somebody to play with my brain,” Maver says. “I investigated and it was either be chair ridden or be able to walk. I had to do something.”
He says he recommends the procedure to anyone considering it saying it’s worth it even just to be able to drive again.
He says his doctors – DeLeo and Wayel Kaakaji – were amazing and that although it doesn’t work for every patient, he and his family are happy it worked for him.
She says they typically try to do the procedure while the Parkinson’s is in its early stages but it can be done with any patient based on symptoms.
“It’s not an end stage salvage thing at all. It’s really not,” she says. “It’s really for the patient who wants to maintain an active lifestyle and isn’t actively controlled on medication and is requiring more and more medication to keep that level functioning.”
Arif Dalvi, director of the Parkinson’s Disease Center at Methodist Hospitals’ Neuroscience Institute in Merrillville, says the center focuses on 21st century treatments of Parkinson’s, including the deep brain stimulation and DatScan technologies.
About a year ago, the hospital started using DatScan, which can estimate what dopamine is doing in the brain. The new test is superior to imaging studies like MRI and CAT scan for diagnosis, says Dalvi, a Methodist Physician Group doctor.
“The older studies just show the structure of the brain, not the chemical imbalance,” he says.
In addition to the DatScan, the center also uses the Unified Parkinson’s Disease rating scale, developed by Columbia University, to diagnose and measure Parkinson’s.
“It’s a very lengthy diagnosis and has a lot of implications short term and long term so we want to make sure we get the diagnosis right the first time around.”
Treatments are individualized following a comprehensive program Dalvi developed with his 15 years experience in surgical and pharmaceutical treatments for the disease.
“We take a holistic approach,” he says. “Instead of just relying on medications alone, these patients come in for an extended visit. They are seen by a physical therapist to see how we can help with walking and balance. They are seen by a pharmacist to see if there are issues with drug interactions. They’re seen by a nutritionist so we can make sure there are no food interactions with their medications. And they are seen by me and measured by the scale. It’s an extensive two-hour visit that really gives us a sense of what this Parkinson’s disease patient is about and then we can tailor treatment for that particular patient.”
For a more comprehensive overview of Parkinson’s, visit emedicine.medscape.com/article/1831191-overview to read a chapter Dalvi co-authored.