Parkinson's Surgery Improves Movement
New Technique Allows Most Patients to Decrease Medication
Last year, Juncos and his colleagues from Cuba and Spain reported they could safely destroy the small cluster of brain cells that causes the slowness and shakiness. In two surgical procedures spaced about a year apart they destroyed nerve cells first on one side of the brain, then on the other side.
This year, surgeons showed that both procedures could be performed in the same surgery -- greatly reducing the patient's risks and costs.
It also provides "a more immediate result," says Juncos.
This small study involved 11 people with moderate to advanced Parkinson's; average age was 59. Each had the double-sided procedure, called subthalamotomy.
In the first months, some patients had movement problems. However, those disappeared when the L-dopa medication was reduced. Overall, there was a 50% improvement in symptoms two years after the procedure, Juncos reports. Patients also had no permanent memory problems or speech deterioration, he adds.
In fact, "much of their depression and apathy also improved," Juncos tells WebMD.
One neurologist sees potential problems with this procedure. The chief disadvantage is the risk of bleeding in the brain, Joseph Jankovic, MD, tells WebMD. He is director of the Parkinson's Disease Center at Baylor College of Medicine in Houston.
"Given a choice, I would still prefer the deep-brain stimulating procedure. In our center, we have a great deal of experience with it and have not yet had serious complications in well over a hundred patients," says Jankovic.
"Intuitively, it makes sense that patients might [bleed] because you're destroying tissue," Juncos tells WebMD. But even with deep-brain stimulation, some patients have [bleeding] because the brain is being probed, he adds.
"Surgery carries some risk, no matter how you do it," says Juncos. "Even if the patient [bleeds], generally [bleeding] is not large. Fortunately, by and large, patients recuperate and retain the benefit."