Can deep-brain stimulation treat my Parkinson’s disease?

Question

Hello doctor,

I am 68 and have Parkinson’s, mostly tremor dominant, but lately I am noticing freezing while walking, and my medication wears off fast. My neurologist suggests maybe deep-brain stimulation, but I am not sure how safe it is at this age.

Are there other non-surgical treatment options currently being used?
Can PT and exercise help slow it down still?

I am scared of falling more and losing independence.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com

I read your query and understand your concern.

It is completely understandable to be concerned as symptoms evolve with Parkinson’s, especially when mobility and independence are at stake. At the age of 68, with a diagnosis of Parkinson’s disease that is becoming less responsive to medication, especially with symptoms like freezing of gait and medication “wearing-off,” it is important to consider all treatment avenues.

Your neurologist’s suggestion of deep brain stimulation (DBS) is in line with current best practices. DBS is often recommended for patients whose symptoms are no longer well-controlled by medication alone.

Here is a breakdown of your options:

1. Deep brain stimulation (DBS):

DBS can be safe and effective even in your late 60s, especially if you are otherwise in good health. Many patients see significant improvements in tremor, rigidity, and “off” times.
As with any surgery, there are risks primarily related to the surgery itself. But long-term cognitive decline is rare when patients are carefully selected.
DBS does not cure Parkinson’s but can dramatically reduce motor symptoms and improve quality of life.

2. Focused ultrasound (FUS):

A non-invasive alternative to DBS, available in select centers.
Currently, FDA (Food and Drug Administration)-approved for tremor-dominant Parkinson’s, and studies are expanding for other symptoms.
Not suitable for all symptoms, like freezing or slowness, and usually only targets one side of the brain at a time.

3. Emerging therapies (gene therapy or cell therapy):

Gene therapy trials are underway, but not yet in routine clinical practice.
Cell replacement therapies are still experimental.
These hold promise for the future but are not widely available or proven in the short term.

4. Physical therapy and exercise:

Specialized Parkinson-specific physical therapy, like LSVT (Lee Silverman Voice Treatment) BIG or gait training, can help with freezing and balance.
Regular aerobic activity, like cycling, walking, or swimming, may slow progression and improve mobility and mood.

Ask your neurologist for a referral to a Parkinson’s physical therapist. If considering DBS or FUS, ask for a comprehensive assessment at a movement disorder center where they evaluate surgical and non-surgical options. Maintain a regular exercise routine and consider joining a support group for both guidance and encouragement.

I hope this helps.

Thank you.