Tuesday, July 29, 2014

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Brain surgery for Parkinson's disease

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Buffalo: Brain surgery for Parkinson's disease
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Parkinson's disease is a movement disorder, and over the last three decades the treatment options were limited - until now.

The symptoms of Parkinson's disease include tremors. Medication is used, but long-term can make the tremors worse. Diagnosing Parkinson's can be done with a brain scan which measures the level of dopamine.

Neurologist Dr. Julie Pilitsis said, "When people become symptomatic with Parkinson's, dopamine levels are about 80 percent reduced."

After medications are no longer effective, some patients are candidates for brain surgery where a deep brain stimulator is implanted.

"Make a small whole in the brain about the size of nickel," said Dr. Pilitsis. "We open up the covering of the brain. We use a special micro-electrode tip which is the finest thread in diameter."

The micro-electrode is then fed deep through the brain to the area which, when stimulated, stops tremors.

When performing surgery on the brain, you need a steady hand, and in this surgery, you need a good ear.

As she passes the electrode through the neurons within the brain, it causes friction which creates a certain sound.

Dr. Pilitsis said, "We listen to what those neurons sound like. What we are looking for when we say 'we got it' is when we move the patient's arm or leg and you can hear a difference in the firing pattern of the individual neuron."

The frequency-like sounds are distinctly different in various parts of the brain.

Dr. Pilitsis said, "Everyone in the operating room can hear what we are doing. We have the micro-electrode which is in the patients' brain. It's connected to a amplifier and a system where we can see what the neurons recording look like and hear them."

Once the stimulator is implanted, a separate device similar to a pacemaker in the placed in the patients upper chest area. Most patients see a 50 to 80 percent reduction in their disease.

"They are able to come off their medications by almost half," said Dr. Pilitsis. "They wonder why they didn't have it sooner."

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