For the most part, Parkinson’s remains a mysterious disease, although scientists agree that its primary cause is likely a combination of genetic and environmental factors. Nonetheless, Parkinson’s disease is an extremely complex and insidious disorder.
No two people likely experience Parkinson’s the same way, but there are commonalities. Parkinson’s affects about one million people in the U.S, and its diagnoses is on the increase, including in those under 50.
Fortunately, medical advances involving both medication and technology-driven surgical therapies are also on the increase to diminish unmanageable tremors, slowness of movement and rigidity as well as non-movement related symptoms that may include anxiety, depression, sleep disorders and cognitive issues.
Patients at Baptist Health with Parkinson’s disease and other movement disorders are increasingly seeing symptom improvements via advanced therapies at Miami Neuroscience Institute and Marcus Neuroscience Institute.
Those treatments often involve medications that replenish the lack of dopamine in the brain of Parkinson’s patients. Dopamine is a “chemical messenger” between neurons that helps us to move around smoothly. The treatments also include surgical procedures, such as Deep Brain Stimulation (DBS) and high-intensity focused ultrasound, or HiFU. There’s also Duopa therapy, which delivers medication directly through a surgically implanted tube in the intestine. It is used in patients with moderate to advanced Parkinson’s disease.
Get Checked — Don’t Ignore Tremors and These Other Symptoms
While these treatments may sound complex or daunting, they are helping thousands of patients with Parkinson’s disease and other movement disorders to deal with otherwise debilitating symptoms. They help make symptoms much more manageable, enabling more patients to resume active and productive lives.
Director of Functional Neurosurgery, Justin Sporrer, M.D., with Baptist Health’s Miami Neuroscience Institute, stresses that the higher rate of Parkinson’s diagnoses, across all ages, should motivate more people to seek medical help from specialists if they start to experience movement-related symptoms, or other signs of the disease.
“If you have a tremor or you’re having difficulty with movements of any sort, you owe it to yourself to at least get it checked out,” said Dr. Sporrer. “It is a common misconception that a tremor or stiffness or discoordination is just a part of getting older. There is a certain amount of slowing down as we get older. But other signs like tremors or the inability to write — that really shouldn’t happen just because we’re 60- or 70- or 80-years-old. It’s worth checking out, and at least then you will be exposed or discuss the correct options with your physician.”
What is Deep Brain Stimulation?
The future definitely is looking brighter for Parkinson’s patients, asserts Sameea Husain Wilson, D.O., the director of Movement Disorder Neurology at Marcus Neuroscience Institute at Boca Raton Regional Hospital.
“Many patients have had DBS (Deep Brain Stimulation) to treat features such as tremors, stiffness, and rigidity. Tremors specifically can be quite debilitating because patients can’t carry out their activities of daily living. After DBS, some patients have tremendous success in that their tremors completely resolve,” said Dr. Husain Wilson. “And they are elated, even though they still have the other motor symptoms.
“So, the future is very bright in terms of helping these patients out. And if you’re a seasoned movement-disorder neurologist, and you’ve seen enough patients, you know exactly who the right candidates are — and the earlier the better to recommend DBS or other treatments for them.”
DBS can be used to treat different movement disorders, including Parkinson’s disease, dystonia and essential tremor. A neurosurgeon implants small electrodes in certain areas of the brain. These electrodes can then send electrical impulses to help control abnormal movements. DBS surgery was first approved in the U.S. more than 20 years ago to treat the symptoms of Parkinson’s disease. More recently, DBS surgery was approved for the earlier stages of Parkinson’s in those with motor symptoms not adequately controlled with medication.
High-Intensity Focused Ultrasound, or HiFU
HiFU is already established as a proven treatment for many movement disorders, but it is becoming more and more of an option for tremor dominant Parkinson’s patients, said Dr. Sporrer. HiFU treatment is available in only a few facilities in the U.S. including Miami Neuroscience Institute. HiFU sends more than 1,000 beams of ultrasound through the skull to a specific location of the brain. It essentially creates an ablation, a procedure to scar or destroy tissue, in a very specific area in the brain. The goal is to destroy lesions or problem areas, such as those that are “disrupting an abnormal circuit in the brain,” explains Dr. Sporrer.
“We know for sure now that it is a very good treatment for tremor dominant Parkinson’s disease,” he said. “In addition, research is being done to perform the ablations at the same areas that we would be targeting in Deep Brain Stimulation for Parkinson’s disease.”
‘It Takes a Village’
While Parkinson’s disease may be the most common movement disorder treated at Miami Neuroscience Institute and Marcus Neuroscience Institute, teams of specialists also treat many other movement disorders and the cognitive and behavioral issues related to these conditions. In some cases, neurologists will recommend physical, occupational or speech therapy to help manage movement disorder symptoms.
“I am inspired every day by the patients that I see because of how hardworking they are or the type of work ethic they have,” said Dr. Husain Wilson. “It takes a village when it comes to managing Parkinson’s disease and other movement disorders. You need a dedicated team that includes a movement disorder neurologist, and perhaps physical, occupational and speech therapists — and a great primary care physician. That’s why we say that getting a movement disorder neurologist in your life as early as possible is the key to get your treatment started and improving your quality of life.”