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-------- Forwarded Message -------- http://www.kumc.edu/Pulse/breaknews/Break_news100295.html > BREAKING NEWS! on Pulse: > > [Image] > > For Immediate Release > > October 2, 1995 > > KU Medical Center Is First U.S. Site for Pallidal Brain Stimulation > for Treatment of Parkinson's > > KANSAS CITY, Kan. -- The first pallidal stimulation for the > treatment of Parkinson's disease in the United States will be > performed Oct. 5 at the University of Kansas Medical Center. > Pallidal stimulation involves threading a thin wire electrode into > the globus pallidus of the brain, the site of abnormal activity in > Parkinson's disease. The electrode, attached to a pulse generator, > sends a high-frequency signal to block the brain's overactive > impulses that result in the tremor and halting steps of Parkinson's. > > "This is certainly not a cure for Parkinson's disease; but the > pallidal stimulation may offer some relief from its symptoms, which > include tremor, slowness, stiffness and gait problems," said William > Koller, M.D., Ph.D., chair of neurology at KU Medical Center. "It > also appears to decrease some of the drug-induced side effects of > Parkinson's, the involuntary movements called dyskinesia." > > The theory is that brain cells which fire to drive normal movement > do not shut off in the Parkinson's disease patient. > > "The circuit in the brain is overactive in patients with Parkinson's > disease," said Steven Wilkinson, M.D., neurosurgeon. "If you disrupt > the circuit, you can improve some of the symptoms. > > Patients are awake during the surgical implantation of the > stimulator and its effects are immediate. A microelectrode with a > single cell recorder is threaded through the brain so the > neurosurgeon can see, as well as hear, which brains cells are firing > too rapidly. The area of increased activity is where the electrode > is implanted. > > KU Medical Center has approval to do five pallidal stimulations. The > study will be used to determine how to optimize the procedure and > how long benefits last. Using current criteria, the first five > patients will be relatively young Parkinson's disease patients, who > have reached the limits of benefit from drug therapy and who > experience significant disability and dyskinesia. > > "There is no information that pallidal stimulation will halt the > progression of the disease; however, it can improve function and > patients will be able do more things," Koller said. "We know some > patients will have dramatic benefits, but it is yet to be determined > how long the benefits will last. " > > Since January 1994, KU Medical Center has implanted electrode > stimulators in 40 patients targeting the brain's thalamus. Thalamus > stimulation has caused significant reduction of tremors in patients > with essential tremor and the tremor of Parkinson's disease. But for > Parkinsonian patients, thalamus stimulation only improves the > tremor, not the drug-induced side effects which alternately cause > episodes of involuntary movements and muscular rigidity or other > Parkinsonian symptoms. One other site in the country, Mount Sinai > Hospital, New York, has approval to implant stimulators for > Parkinson's disease in a different area of the brain, the > subthalamius nucleus. > > A surgical procedure called a pallidotomy, which actually destroys > tissue in the globus pallidus, has been tried at other medical > centers for treatment of Parkinson's disease. Pallidotomies first > were used 30 years ago but grew out of favor with the advent of > Levodopa, the drug of choice for Parkinson's disease. There has been > a resurgence of interest in the procedure as patients reach the > limits of benefit from Levodopa and also experience "on periods," > defined by abnormal movements, and "off periods," defined by > rigidity, from long-term use of the drug. > > Koller said that pallidal stimulation may offer some advantages over > the pallidotomy: 1. no brain tissue is destroyed 2. the frequency > and strength of stimulation can be adjusted to the needs of each > patient 3. the stimulus can be removed if there is an adverse effect > and 4. stimulation can be done on both sides of the brain while a > pallidotomy can only be done on one side because of risks of speech > and swallowing difficulties. Wilkinson and Koller plan to perform > pallidotomies after the five pallidal stimulations. > > "There is a lot of scientific interest and a lot of potential to > help Parkinson's disease patients when we have run out of other > options," Koller said. "We still need to learn more about these > procedures. They are investigational and there are some risks > involved." > > (Story by Peggy Graham, University Relations, 913-588-5240) > -------------------------------------------------------------------- > Archive of previous Breaking News Items