Parkinson’s disease can be treated with surgery, most notably through a procedure called **deep brain stimulation (DBS)**. DBS is currently the most established and widely used surgical treatment for managing motor symptoms of Parkinson’s disease, especially when medications alone are insufficient or cause problematic side effects.
Deep brain stimulation involves implanting thin electrodes into specific areas of the brain that control movement. These electrodes are connected to a small device called an impulse generator, which is implanted under the skin near the collarbone or abdomen. The impulse generator sends electrical pulses to the brain, helping to regulate abnormal brain activity that causes symptoms such as tremors, stiffness, and slow movements. This electrical stimulation can significantly reduce these motor symptoms and improve quality of life for many patients.
DBS is typically considered for people with Parkinson’s who:
– Have motor symptoms that are not well controlled by medication
– Experience medication side effects like dyskinesias (involuntary movements)
– Have fluctuations in symptom control throughout the day
The benefits of DBS can last for several years, often five years or more, though individual results vary. It is important to understand that DBS is not a cure for Parkinson’s disease; it does not stop the progression of the disease but helps manage symptoms more effectively than medication alone in many cases.
Besides DBS, other surgical options exist but are less common. These include procedures like **pallidotomy** and **thalamotomy**, which involve creating small lesions in specific brain areas to reduce symptoms. These surgeries are generally considered when DBS or medications are not suitable or effective.
More recently, **focused ultrasound** has emerged as a noninvasive surgical option. It uses targeted ultrasound waves to create precise lesions in the brain without the need for incisions. While promising, focused ultrasound is still relatively new, and long-term data on its effectiveness and safety are limited.
Surgical treatment for Parkinson’s is a complex decision that involves careful evaluation by a team of neurologists and neurosurgeons. Candidates for surgery undergo thorough assessments to ensure they are healthy enough for the procedure and to determine the best surgical approach tailored to their symptoms.
DBS surgery itself involves two main steps: first, the placement of electrodes in the brain, often guided by advanced imaging and sometimes robotic assistance; second, implantation of the impulse generator device under the skin. Patients usually stay in the hospital overnight and are monitored closely. After surgery, the device settings are adjusted over time to optimize symptom control while minimizing side effects.
While DBS is generally safe, it carries risks common to brain surgery, such as infection, bleeding, or hardware complications. There can also be side effects related to stimulation, including speech difficulties, balance problems, or mood changes, which can often be managed by adjusting the device settings.
Ongoing research is expanding the potential of surgical treatments for Parkinson’s. Innovations include gene therapy approaches and improvements in surgical techniques and imaging. These advances aim to enhance the safety, effectiveness, and range of symptoms that can be treated surgically.
In summary, surgery, particularly deep brain stimulation, is a well-established and effective treatment option for managing Parkinson’s disease symptoms when medications are insufficient. It offers many patients improved motor function and quality of life, though it requires careful patient selection, surgical expertise, and ongoing management. Other surgical methods and emerging technologies continue to broaden the landscape of Parkinson’s treatment options.