Parkinson’s: A disease with no cure but many possibilities

Like any major illness, detecting Parkinson’s disease at its early/nascent stage is crucial to reduce its repercussions and enhance the quality of life.

It usually comes to light when we witness any or all of the easily recognizable motor symptoms such as a person’s hands shaking constantly at rest, generalized stiffness, slowness, difficulty in walking, stooped posture, and decreased facial expression. However, we can also identify certain ‘early’ signs even before the above symptoms become apparent: unexplained insomnia, smelling difficulty, new-onset depression, and constipation. Not only can this improve the scope of recovery at the earliest but it also enables the patient to live better.

Did you know? It is truly amazing that medical science has come up with so many possible treatments for a disease with relatively no known cause. Genetics cause about 10-15% of all Parkinson’s disease cases. The remaining 85-90% of cases are considered sporadic.

The progressive nature of the disease has put roadblocks in the path of medical science to manufacture the ‘ultimate cure’.

At present the medication administered depends on the degree of functional and cognitive impairment and the ability to tolerate antiparkinsonian medication.

In the initial few years, medications are able to control symptoms in most patients. In cases that are more advanced, specific & precise surgical interventions have shown the way to improved results.

Lesional surgery: Lesional surgery involves specific targeting & ablation of certain deep parts of the brain where small and accurate lesions are made to control movement. However, this type of “one-time” surgery is counter-intuitive as the nature of the disease is progressive.

Deep Brain Stimulation: Popularly known as ‘Brain Pacemaker’ surgery, it is one procedure that is immensely helping patients get one over Parkinson's disease. It involves implanting electrodes within certain deep-seated areas of the brain. These electrodes, controlled by a pacemaker inserted in the chest, modulate abnormal impulses that effectively reduce symptoms like stiffness, slowness and tremors as well as decrease the need for medications. The advantage of this therapy is that it is reversible & adaptable and therefore can be ‘programmed’ from time to time depending on the disease progression. Resultantly the beneficial effects are sustained for the entire lifetime.

A recent success story that fills me with satisfaction is that of a 60-year-old banker from West Bengal who, for the first time in years was able to enjoy his dream vacation in the hills thanks to  Simulation surgery conducted at our Institute of Neurosciences.

I believe that the technology used in the patient’s surgery is the future of deep brain stimulation whereby we can modulate the entire brain circuits dealing with specific brain functions rather than just stimulating static brain targets. Furthermore, the procedure enables us to modulate the electrical impulses as per every individual’s need and causes little to no side effects.

As modern technology delves deeper into the medical field, DBS continues to become more effective and accurate with the evolution of frameless robotic deep brain stimulation surgery, satellite-aided remote programming of brain pacemaker, closed-loop feedback technology and so on & so forth.

To conclude, Parkinson’s disease doesn’t have to result in prolonged suffering if prompt action is taken. While detecting the early signs is key, a holistic combination of medication, surgery (if needed) and rehabilitation therapy have shown good results. With the right experts, patients can go on to have a near-normal life expectancy with decent quality of life.