“There are three major hallmarks to Parkinson’s disease,” Dr. Feldman said. “Bradykinesia, which means slowness of movement, rigidity and a tremor at rest.”
Treatment options for the disease have primarily centered on dopamine replacement therapy since Levodopa was first developed in the 1960s. Over time, other medications have been developed to enhance the efficacy of Levodopa, but the main goal of medicinal therapy has remained the same, Dr. Feldman said.
Patients who manage symptoms with medication often see success in the first few years of their diagnosis, and have relief from relatively small dosages of medication a day. However, as the disease progresses, the time between doses shortens and the swings of what is known as their “on” and “off” state becomes more drastic. A person’s quality of life begins to suffer when the length of relief from symptoms and the timing of when their “off” state becomes more unpredictable, Dr. Feldman said.
DBS is an incredible option for Parkinson’s disease patients, however, only selected individuals benefit from it. Dr. Feldman works closely with Dr. Torres-Reveron to determine which patients are good candidates for the procedure.
Patients must have a significant improvement on the United Parkinson’s Disease Rating Scale while on Levodopa. The United Parkinson’s Disease Rating Scale was developed by the Movement Disorders Society and is used widely in research trials, as well as by neurologists to measure how a Parkinson’s patient is progressing in their disease as time goes on. The scale looks at all aspects of a person’s functioning.
“It’s not just the severity of their tremors, but how they work in daily life, how they perform certain functions, limitations they have and any problems associated with other disease processes,” said Dr. Torres-Reveron. “We then look at how responsive they are to medication and how many years they have had the disease. The criteria calls for them to have had it for at least four years.”
Those who do fit the criteria and undergo the procedure experience a new way of life, he said.
“It can be pretty dramatic,” Dr. Torres-Reveron said. “Imagine having to carry your pills everywhere and maybe at one point forgetting to bring them along. Now you’re experiencing symptoms like horrible rigidity. DBS gives relief from that and a new peace to patients with the disease.”
For more information on deep brain stimulation or to find a Premier Physician Network physician near you, go online to www.premierhealthspecialists.org/neuro.
Premier HealthNet is one of the largest groups of pediatrics, family medicine, internal medicine, and urgent care practices in southwest Ohio. For more information, go online to www.premierhealthnet.com/news.