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Parkinson's treatment inspires hope SCOTT FONTAINE; [log in to unmask] Published: January 3rd, 2008 01:00 AM Every second of every day, battery packs embedded in Rich Hammermaster's chest send pulses of electricity through wires implanted on the sides of his neck to electrodes deep in his brain. The voltage of the electricity is low - if a static spark of the same strength jumped from a door handle to your hand, you wouldn't notice. The treatment is called deep-brain stimulation, and it's been approved in the United States for the past five years. It's not a cure, but the technology - described as a pacemaker for the brain - has improved the lives of Hammermaster and thousands of others with Parkinson's disease. "The first 15 minutes of your mornings are the toughest with Parkinson's," said the Puyallup resident. "I had trouble getting out of bed. Since I've had the surgery, I can get right out of bed. I can turn over and kick my cover up. I couldn't do that without the volts." Parkinson's disease is marked by a deterioration of the brain cells that govern dopamine, the neurotransmitter that helps regulate neurons. When the brain has insufficient dopamine, some neurons work erratically. That leads to stiffness and other motor-activity symptoms in patients. Deep-brain stimulation doesn't actually stimulate the dopamine-producing cells, said Peter Nora, a neurosurgeon at Swedish Medical Center in Seattle. The electrodes quiet the cells. That's the general concept of how the surgery helps patients with Parkinson's. The specifics are a bit fuzzier. "The short explanation is nobody knows how it works or why it works," said Nora, who operated on Hammermaster and about 260 other patients. "We take an equation that's out of whack and restore it to something closer to normal activity." Doctors affix a frame to the skull to keep the head in place, and a CT scan is performed to target the location for the electrode: a 7-by-9-by-7-millimeter area. A hole is drilled in the skull, and the surgeon places the electrode in. The patient, still awake at this point, answers a series of questions to determine the stimulation's effectiveness. A wire is then tucked under the skin and run to a battery implanted in the upper torso. The science behind deep-brain stimulation is rooted in the 1940s and '50s, when doctors tried treating motor impairments by killing certain brain cells, said Peter Shin, a neurosurgeon on medical staff at St. Joseph Medical Center. That practice was largely abandoned with the introduction of drugs, but when doctors realized Parkinson's patients couldn't rely on medication indefinitely, research into deep-brain stimulation began in the 1980s. Researchers are experimenting with the technique to treat Tourette syndrome, chronic pain and depression. The side effects of DBS can range from depression to euphoria but are rarely permanent, according to a study published in the Journal of Geriatric Psychiatry and Neurology. The abstract of the 2004 study, written by two neurologists in the United Kingdom, is published on the National Institutes of Health's Web site. The procedure has risks. About 2 percent to 3 percent of patients experience a brain hemorrhage, though not all complications lead to severe impairments, according to the Cleveland Clinic, one of the nation's top hospitals. Before the Food and Drug Administration approved the technique for Parkinson's in 2002, it was available in Europe. Some of Hammermaster's friends had flown overseas to get the technique performed. When he asked them about the surgery, they were unanimous and adamant: Have it done, they said. Hammermaster was taking more than 50 pills a day to control his symptoms. Sports had always been important to him - he was a football player at the University of Washington and the University of Puget Sound and later coached basketball at Puyallup High School - but he began avoiding games. He had surgeries in October and November to have the electrodes installed. Spanaway's Jessica Christie is 31 and likely one of the youngest patients to receive the surgery. She began showing tremors in her left arm and a slow walking gait in early 2002, but doctors were hesitant to diagnose someone so young with Parkinson's. It wasn't until October 2003 that Christie, a nurse at Tacoma General Hospital, received her diagnosis. She spent plenty of time browsing online forums like Parkinson Profile trying to find others in her situation. The youngest people she has found are in their mid-40s. Christie underwent DBS on Jan. 9 at St. Joseph and said it's made a major improvement on her symptoms. "Before the surgery, I hated leaving my house and going on errands. I felt like people were always looking at me," she said, adding that handling cash and holding a child were sometimes challenges. "Thank goodness for this surgery. It's done a lot for me. It's been so helpful." Scott Fontaine: 253-320-4758 Rayilyn Brown Board Member AZNPF Arizona Chapter National Parkinson's Foundation [log in to unmask] ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn