Surgeon tries new Parkinson’s treatment

A northwestern Illinois woman Thursday became the first Parkinson’s disease patient at UW Hospital and Clinics to undergo deep brain stimulation, a procedure in which electrodes are placed deep into the brain and connected to a pacemaker-like device that delivers electrical impulses to disable certain nerve cells.

When the full process is complete, the patient will be able to control her symptoms by using a magnet to adjust the amount of electrical stimulation her brain is receiving.

The goal of the procedure is to reduce or eliminate the disabling tremors, increase her mobility and reduce the need for high doses of medicine.

In a nearly six-hour procedure during which the patient was conscious and speaking, neurosurgeon P. Charles Garell placed an electrode into a small region of the brain that processes and relays information before they go to the muscles.

In future procedures, Garell will place a controller device under the skin near the collarbone. This stimulator will be connected to the electrodes and will be used to produce rapid bursts of electrical stimulation to certain nerve cells in the brain.

Deep brain stimulation was approved by the Food and Drug Administration in 1997 for treatment of tremor problems, including essential tremor and Parkinson’s.

Parkinson’s Disease is a chronic, progressive neurological disorder that results in tremors, muscle stiffness, and slow movement. The disease results from a loss of brain cells that produce dopamine, a neurotransmitter that is important to coordinated movement.

About 1 million Americans have Parkinson’s disease. Most patients are successfully treated with medications, particularly L-Dopa, which is converted to dopamine in the body. But as the disease progresses, medications often become less effective or may produce disturbing side effects. Surgical approaches of various kinds have been used with patients whose disease is not well controlled with medication.

“Surgical treatments for Parkinson’s have a long history,” says Garell, who is also assistant professor of neurosurgery at UW Medical School. “But deep brain stimulation has the powerful advantage of being reversible. Brain cells are not destroyed in the procedure; they are stimulated at various rates depending on the patient’s symptoms.”

Garell, who studied the deep brain stimulation procedure in France with one of the world’s leaders in functional neurosurgery, has treated three UW patients through this approach. The first patient, who was treated for essential tremor, had outstanding results; her tremors completely disappeared. The second patient, who suffered from dystonia (a movement disorder involving involuntary muscle contractions), had surgery only recently and his outcome is not yet known as results typically require several months to show.

Garell joined the UW Medical School faculty in June. Following medical school, he was awarded a fellowship from the American Association of Neurological Surgeons for a year of study in neurosurgery in Grenoble, France.