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Parkinson

PARKINSON: LAUNCH deep brain stimulation

By Severina Cantaron

It's called 'deep brain stimulation' and offers a new opportunity treatment for patients with Parkinson's disease who no longer respond to drug therapies.
The first planting of a pacemaker connected to the deep brain electrodes were made several weeks ago at the Department of Neuroscience, National Institute Regina Elena (IRE) by Professor Carmine Carapella, Neurosurgeon Regina Elena, in collaboration with Dr. Carlo Colosimo , a neurologist at the University La Sapienza.

"The first speech ever," he recalls Carapella Professor, Head of the Section of Stereotactic Neurosurgery, Department of Neuroscience IRE, "was made by Professor Benabid in Grenoble, France as well 20 years ago. Since then, many neurosurgical centers in Europe and around the world have adopted this procedure. In Italy, and especially in central-south, not many centers are able to offer deep brain stimulation as a treatment option for patients and provide all the necessary assessments in the pre-and post-surgical (clinical, neuropsychological, imaging). The results obtained in more than 80,000 patients around the world confirm that deep brain stimulation is an effective treatment, if ever managed by a team of qualified neurosurgeons and neurologists. "

What should I do
The treatment involves the 'intracerebral implant, in a small area of \u200b\u200bthe thalamus or basal ganglia, a stimulating electrode connected to a pacemaker. Electrical stimulation, induced in a brain area that acts as a 'switch on some circuits of the movement, helps control the symptoms of the disease and reduces the use of drugs especially when they are responsible for undesirable effects (movement disorder volunteers, behavioral disorders).
Since there is currently no cure for Parkinson's disease and there is no way to prevent its progression, the goal is to manage the symptoms return as long as possible to their deterioration and to minimize the 'onset of new symptoms.
Patients that can perform this type of intervention is 10% of those suffering from Parkinson's disease. The plant is in fact particularly indicated in patients in whom drug therapy, after several years, no longer able to manage severe dyskinesia or motor instability.
The results, measured at a distance from the installation of the neurostimulator, show how one can achieve a significant improvement in both quality of life of motor (tremor, rigidity, dyskinesia), a reduction of drug doses in the order of 50 % on average. Currently, in addition, is considering applying deep brain stimulation (DBS) for intractable epilepsies and specific forms of intractable headache.

But how deep stimulation?
The 'heart' of the unit is the neurostimulator, a small titanium device, similar to a cardiac pacemaker, which contains the battery and a microprocessor. Implanted under the skin of the chest produces electrical pulses needed for stimulation. There are four terminal electrodes, a method of image-guided stereotactic MRI, are implanted in the brain areas involved in the disease.
therapy is reversible, in practice it is possible to interrupt the stimulation or completely remove the device at any time. For optimal performance of the system is fundamental careful selection of patients, together with an effective integration of neurosurgeons, neurologists and neuropsychologists.


The Parkinson
in our country are over 200 thousand people affected by Parkinson's disease, degenerative neurological disease that usually affects the sixties, while 25% of patients the onset is before age 50.
To date there is no preventive care and the causes are largely unknown. In the brain we observe the degeneration of some neurons to release dopamine and Members impaired communication circuits involved in motor control.