Parkinson’s treatment

Parkinson’s is a movement disorder that affects approximately 145,000 people in the UK and over 10 million people worldwide.

It is both progressive – meaning it advances over time – and degenerative, because it is characterised by a continuous decline of dopamine-producing cells in the motor region of the brain.

Dopamine declines in Parkinson’s patients, reducing their ability to control or initiate movement, resulting in symptoms like tremor, slow movement, rigidity, and postural instability.

It is natural to seek answers after a Parkinson’s diagnosis. Why did this happen? Did I cause it? Are my children or grandchildren at risk? Unfortunately, the exact cause of Parkinson’s disease is still unknown. Researchers believe Parkinson’s disease is caused by a complex combination of factors involving genetics or familial history, environment, and aging. Studies haven’t been able to place more weight on one of those factors over another. As with many things about Parkinson’s, the cause is diverse, personal, and dependent on the individual.

Having Parkinson’s diease can feel confusing—and even invading—as symptoms come and go, tremors appear, and simple tasks become difficult. Understanding Parkinson’s helps you remove the mystery of your diagnosis.

Motor symptoms can make the activities of everyday life challenging.  

Non-motor symptoms: Even though Parkinson’s is a movement disorder, the non-motor symptoms can have just as a big impact on your quality of life.

• Every person living with Parkinson’s will have an individualised treatment plan. 
• The optimal medicine plan varies from person to person, and your specialist hospital team can help you find the right medicine, or combination of medicines, to give you the most relief with the fewest side effects. 
• Over time, as medications become less effective, doses may be increased, and new medications can be added such as levodopa or dopamine agonists and more. Levodopa is a common medicine used for Parkinson’s, and you must have trialled Levodopa before being considered for DBS.¹

You already know that exercise should be part of your weekly routine. It keeps our minds and our bodies in alignment. This is even more crucial as you face your Parkinson's diagnosis.

• While exercise can’t treat Parkinson’s disease, it has been shown to slow the decline. In a 10,000 patient clinical trial, at least two and a half hours of physical activity each week – including strength, flexibility and aerobic exercise has been shown to prolong better quality of life. 
• To be accepted for DBS surgery, your specialist team will advise you to be aerobically fit as you can be.

As Parkinson's progresses, your care team may start talking to you about advanced care options, such as pumps, MRI-Guided Focused Ultra sound or DBS.

• MR-guided focused ultrasound (MRgFUS) provides an incisionless treatment option for tremor-dominant unilateral Parkinson’s patients who do not respond to medications. Candidates for treatment must be Parkinsonian tremor patients 30 years or older.

• Deep Brain Stimulation (DBS) is often a surgical procedure under general anesthesia designed to help control motor symptoms while allowing for a reduction in medication. DBS uses a device similar in size and shape to a cardiac pacemaker. It sends signals to your brain to help control the symptoms of movement disorders. Your surgeon will place one or two wires called ‘leads’ in the brain. 
• The leads are then connected to the stimulator and the stimulator is placed under the skin in the chest or in the abdomen. When the stimulator is turned on, it produces mild electrical impulses that stimulate a specific target within the brain. 
• The stimulation may help regulate the incorrect signaling in the brain, improving some of the symptoms of movement disorders. For many people, daily activities which had been impossible to perform previously could become feasible again.

• Always speak to your clinician to see if this could be a treatment for you. 
• To be accepted for DBS surgery, your specialist team will advise you to be aerobically fit as you can be.

For people with Parkinson’s, ideal candidates are those who:

• Have responded positively to levodopa treatment but are unable to control the motor symptoms of Parkinson’s with medicine alone.
• Are diagnosed with Parkinson’s for at least 5 years.

While this may be the progression of Parkinson’s disease, there are numerous therapies, specialists, and interventions available to you. Be vigilant about your treatment and exploring your options. As you notice your medication is becoming less effective, tell your doctor right away. Waiting too long may mean you’ll miss an opportunity for a life-changing treatment like DBS, which relies on acting during the “window” when medications begin to become less effective but haven’t fully stopped working.

Signs of advanced Parkinson's disease include, for example, taking tablets so frequently that those affected hardly have time to eat. Life becomes less and less predictable due to sudden off-phases.

The 5:2:1 rule can be used to estimate whether this point has already occurred or not.

In the past 50 years there have been discoveries that have revolutionised our understanding of Parkinson’s and the brain. There are several trials happening to either slow the progression of Parkinson’s, stop Parkinson’s and even potentially reverse Parkinson’s.  Keep up to date with all the research and resources going on to support the cure for Parkinson’s here.

To increase awareness and understanding, Boston Scientific actively participates in community education and builds strong relationships with the local Parkinson’s community.