"Pacemaker For The Brain" May Offer Hope To Sufferers Of Severe Parkinson's Disease

Peter A. Pahapill, M.D., Ph.D., director of Functional, Stereotactic and Restorative Neurosurgery, in the Division of Neurosurgery at Penn State Hershey Medical Center is conducting the study. It calls for 20 Parkinson's patients to undergo Chronic deep brain stimulation or DBS treatment and observation over a period of three years. The study is approved by the U.S. Food & Drug Administration.

"There are thousands upon thousands of patients in the United States alone with terrible qualities of life because of their very advanced Parkinson's disease," Pahapill explains. "Preliminary co-operative studies in the United States, Canada and Europe have shown very promising results in these patients with stimulation in specific areas in both sides of the brain. Certainly, the procedures seem to be both effective and safe. However, further studies are needed to confirm and even improve further upon the results so far."

Parkinson's Disease (PD) is a progressive degenerative neurological disease that strikes men and women of all ethnicities, but is more prevalent among people over age 64. The disease affects roughly one million Americans, including such well-known individuals as actor Michael J. Fox and boxing legend Muhammad Ali.

Symptoms of PD include tremors, rigidity, slowness of movement, and problems with balance and walking. In Pahapill's words, Parkinson's disease interferes with a person's ability to "enjoy a life with independence and dignity."

DBS is an alternative therapy for Parkinson's disease. It involves the use of electronics -- "a pacemaker for the brain" -- to stimulate and modify brain activity. DBS is reversible, adjustable and may create less persistent adverse effects than conventional operations that involve the intentional scaring of brain tissue.

According to Dr. Pahapill, DBS involves the insertion of three mechanical components: an electrode lead; an extension; and an implantable pulse generator or IPG. The lead consists of small insulated wires connected to four electrode contacts. The lead is implanted in the brain, near the site where traditional surgical treatments would call for a permanent lesion to be made, and is connected to the extension cable that connects to the IPG. The IPG is implanted in the subcutaneous tissue below the clavicle (collar bone).

The IPG operates much like a cardiac pacemaker to generate electronic signals that are delivered to the brain through the extension and electrode lead. A physician programs the IPG to deliver the appropriate stimulation by specifying the intensity, rate and pulse width. The physician can as well as choose which lead contacts receive stimulation. Programming can be done by physicians during office visits and is painless.

Studies show that about 90% of Parkinson's sufferers experience complete or nearly complete elimination of the physical tremors or shaking associated with the disease after undergoing DBS treatment. Preliminary data also shows striking improvements in controlling other debilitating signs and symptoms of PD as mentioned above.

While DBS neither cures Parkinson's disease nor prevents its progression, Dr. Pahapill is convinced that this alternative treatment can minimize the impact of its symptoms and improve the overall quality of life for Parkinson's patients. He hopes this new study will further prove this assertion.

"We would hope that with proper FDA-approved studies, such as ours, the results will help support the provision of this therapy to many more patients suffering from parkinsonism in our country."

Participants in the DBS study must be diagnosed Parkinson's patients and must be over 18 years of age. They can be male or female, although pregnant women are not permitted to participate. Participants in the study will receive optimal medical and surgical treatment for Parkinson's Disease free of charge.

Volunteers who meet the study's criteria should call the Medical Center's toll-free CareLine at 1-800-243-1455.