Can DBS improve my father's Parkinson's symptoms?

Question

Hello doctor,

My 67-year-old father was diagnosed with early Parkinson’s disease a year ago. His tremors and stiffness have been gradually worsening, and he is also experiencing sleep disturbances and mild changes in mood.

We want to know what the best combination of drugs, physio, and lifestyle changes is that can support him to retain his independence and quality of life for as long as we can.

Is deep brain stimulation (DBS) also an option at this early stage in Parkinson's, or is it normally only recommended in the later stages?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

You are doing the right thing by asking early. Parkinson’s disease (PD) benefits most from a comprehensive, balanced approach.

The main treatment is Levodopa-Carbidopa, which helps to reduce tremor, stiffness, and slowness. In the early stages, Monoamine Oxidase-B (MAO-B) inhibitors, such as rasagiline or selegiline, or dopamine agonists, such as pramipexole or ropinirole, may be added or used alone if symptoms are mild. The goal is to use the lowest effective dose and adjust it gradually with regular follow-up by a neurologist.

Daily physical activity is very important. Stretching, balance training, brisk walking, cycling and yoga help to maintain flexibility and gait. A neurophysiotherapist can develop a home exercise program to assist with the prevention of stiffness and falls.

A regular sleep schedule, a diet high in fiber, and plenty of fluids can help prevent constipation. Mental stimulation such as reading and doing puzzles and regular social interaction can help slow mood and cognitive decline. Speech therapy may be useful if the voice is soft or unclear.

Deep brain stimulation (DBS) is generally considered later when medication is effective but causes side effects such as dyskinesia or wearing-off periods. Early intervention is generally not required, but discussing it and understanding it now can be useful for future planning.

See your neurologist regularly, optimize your medications, and start structured physiotherapy and lifestyle changes now, as these measures can help you remain independent for many years.

I hope this helps.

Thank you and take care.

Regards