What is Parkinson's Surgery?

What is Parkinson's Surgery?

Parkinson's disease is a neurodegenerative disorder that affects the central nervous system and is particularly associated with issues in movement control. This disease arises due to the loss of dopamine-producing cells in the brain and is characterized by symptoms such as tremors, muscle stiffness, slowness of movement, and balance problems. While there are many treatment options available for Parkinson’s disease, in certain cases, surgical intervention may be considered. Parkinson’s surgery is a treatment method aimed at alleviating symptoms and improving the patient’s quality of life.

This surgical approach is typically considered when medication and other conventional treatments are ineffective or fail to provide satisfactory results. Parkinson’s disease leads to the loss of nerve cells, which affects movement control, and Parkinson's surgery generally focuses on alleviating or eliminating motor control issues.

What Are the Treatment Methods in Parkinson’s Surgery?

Parkinson's disease is typically managed with medications in its early stages. However, as the disease progresses, surgical intervention may be required. Parkinson’s surgery encompasses a range of treatment methods that effectively help manage symptoms and improve the patient’s quality of life. The primary Parkinson’s surgery options include:

Deep Brain Stimulation (DBS): Deep Brain Stimulation, also known as brain pacemaker surgery, involves implanting a small device that regularly stimulates nerve cells. This device usually consists of a generator placed in the chest area and electrodes implanted in the brain. These electrodes send electrical signals to specific areas of the brain, aiming to reduce Parkinson’s symptoms. The DBS procedure typically occurs in three stages. First, surgeons create brain maps to identify optimal points for electrode placement. Next, the generator and electrodes are implanted. In the final stage, the device is programmed and adjusted to the patient’s individual needs. After surgery, patients generally experience significant improvement and a reduction in symptoms. Benefits of DBS include improved quality of life, reduced side effects from medications, and enhanced motor control. However, like all surgeries, DBS carries certain risks, such as infection, generator malfunction, or complications with electrode placement, which should be considered when evaluating this surgical option.

Ablative Surgery: Ablative surgery aims to alleviate Parkinson’s symptoms by carefully creating controlled damage to specific areas of the brain. This surgical procedure is usually considered for patients who do not respond to medication therapy or cannot tolerate its side effects. Surgeons create a brain map to identify targeted areas. Using laser or electrodes, energy is applied to the selected regions to regulate uncontrolled cell activity. Following surgery, patients generally experience noticeable improvement, though individual variations should be taken into account. Ablative surgery can significantly reduce symptoms, decrease dependence on medication, and improve the patient's quality of life. However, this surgical option also carries risks. Brain interventions are always risky and may lead to complications such as infection or excessive loss of motor control.

How is the Treatment Planned in Parkinson’s Surgery?

The treatment process includes a thorough assessment of the patient’s overall health and the severity of Parkinson’s symptoms. Before recommending surgery, the patient’s neurological condition is examined in detail, assessing the severity and extent of symptoms like tremors, muscle stiffness, and balance issues. Conditions that indicate the need for surgical options include:

• Lack of Response to Medication: Many Parkinson’s patients receive medication therapy to control symptoms, but in some cases, symptoms may remain uncontrolled.
• Medication Side Effects and Tolerance: For some patients, side effects of medications become intolerable.
• Movement Limitations and Difficulty with Daily Activities: As Parkinson's disease progresses, movement restrictions can increase, leading to difficulties with daily activities.
• Decrease in Dopamine Effectiveness: Dopamine production decreases in Parkinson's patients, and surgery can increase dopamine effectiveness by targeting specific areas of the brain.
• Fluctuations and Dyskinesias: Patients may experience motor fluctuations and dyskinesias (involuntary movements) in addition to medication therapy.
• Reduction of Medication Dependence: Surgery can reduce the patient's dependence on medication, thereby minimizing side effects.

When surgery is decided upon, brain mapping is created for both ablative and stimulation methods to allow precise intervention in specific areas. The specialist explains the appropriate surgical options for the patient’s condition in detail. The benefits and risks of different methods, such as ablative surgery and DBS, are shared with the patient. An individualized treatment plan is created based on the patient’s overall health, lifestyle, and preferences. This plan includes the type of surgery, the procedure, and expectations.

The Role of Surgery in Parkinson’s Disease

Parkinson's disease is a neurodegenerative disorder caused by damage to nerve cells. For patients who do not respond to traditional treatments or cannot cope with side effects, Parkinson’s surgery offers several significant benefits. The advantages of Parkinson’s surgery for patients include:

Noticeable Reduction in Symptoms: Parkinson’s surgery can be effective in alleviating key symptoms of the disease, such as tremors, muscle rigidity, and slowness of movement. This can help patients carry out daily activities with greater ease.

Reduction in Medication Use: In cases where patients cannot tolerate Parkinson’s medications or when these drugs are ineffective, surgical intervention may be considered. Parkinson’s surgery has the potential to reduce or even eliminate the need for medication, thereby enhancing patients’ quality of life.

Improvement in Mobility: The goal of Parkinson’s surgery is to help patients perform daily activities more comfortably. Improved mobility can increase patients’ independence and raise their standard of living.

Enhancement of Motor Functions: Surgical interventions can improve patients' motor functions. This improvement aids in better coping with motor difficulties, such as movement limitations, imbalance, and coordination problems.

Emotional and Psychosocial Recovery: Gaining control over symptoms can support emotional and psychosocial recovery. Increased independence and the ability to handle daily challenges can enhance mood and life satisfaction.

Long-Term Effectiveness: Parkinson’s surgery can be effective in the long term. Deep Brain Stimulation (DBS), in particular, has proven successful in controlling symptoms over time, contributing to the sustainability of treatment outcomes.

Increase in Quality of Life: Controlling symptoms and reducing medication usage after Parkinson’s surgery can improve patients’ overall quality of life, positively impacting social interactions, daily activities, and mental health.

Personalized Adaptation: Parkinson’s surgery can be tailored to the individual needs and conditions of each patient, making it a personalized treatment option.

Surgical procedures for Parkinson’s disease may not be suitable for everyone and may carry risks. Therefore, surgical options should be evaluated by a specialized healthcare team based on factors such as the patient's individual condition, symptom severity, and overall health status.