EMORY PHYSICIANS USE DEEP BRAIN STIMULATION FOR PARKINSON'S TREATMENT

About 1 million Americans suffer from Parkinson's disease, a degenerative neurological disorder for which there is no cure. While at first medication can usually control symptoms of the disease, over time, the disease becomes progressively worse and the medications can cause significant side effects.

Mrs. Sybil Guthrie is one of two patients who have received a new treatment called deep brain stimulation on both the left and right side of the brain at Emory University Hospital for symptoms of Parkinson's disease. This procedure, which was developed in France, is now being studied at several centers in the United States, including Emory.

Deep brain stimulation (DBS) involves surgical implantation of an electrode into the brain which is connected to a pulse generator device under the skin near the collarbone. The DBS device delivers controlled electrical stimulation to those brain regions implicated in the production of Parkinson's symptoms. After implantation, patients use a hand-held magnet to turn the system on and off.

"The great thing about this procedure is that it is reversible," says Emory University neurologist Jerrold Vitek, PhD, MD, "The level of stimulation can be adjusted externally to meet individual patient needs." Other members of the Emory University deep brain stimulation team include: Mahlon DeLong, MD, chair of neurology and Roy Bakay, MD, vice chair of neurosurgery.

Although, it is unknown how far into the future the results will last, the first patient at Emory to receive the same treatment as Mrs. Guthrie has shown continued positive effects for more than one year. At present, the procedure has been approved by the Food and Drug Administration for treatment of tremor only. It currently is being evaluated for its effectiveness in patients with Parkinson's disease such as Mrs. Guthrie, as well as for patients with dystonia, a little-known and yet fairly common movement disorder that causes muscles to pull or spasm.

Made by Medtronic, Inc., the deep brain stimulation device controls the major symptoms of Parkinson's -- rigidity (stiffness or inflexibility of the limbs and joints), bradykinesia/akinesia (slowness or absence of movement), gait disorder, and tremor (involuntary rhythmic shaking). Deep brain stimulation also is effective in controlling drug-induced dyskinesia (abnormal, involuntary movement), a side effect associated with antiparkinsonian drug therapy.

By alleviating Parkinsonian symptoms, the patients ability to function normally and independently is greatly improved, and medication levels may be reduced.