Cutting-edge treatment for Parkinson's DiseaseDate: 12/04/2018
More than 80,000 Australians live with Parkinson’s Disease and Cabrini is fortunate to have two doctors – neurologist Dr Wesley Thevathasan and neurosurgeon Mr Kristian Bulluss – who are leading the way in Deep Brain Stimulation (DBS) – a surgical intervention addressing the symptoms associated with related movement issues.
The treatment is helping many people affected by Parkinson’s Disease, which has obvious symptoms such as tremor, muscle rigidity, slow movement, sometimes a shuffling gait, lack of arm swing and speech problems. The condition, which shows first signs of onset between 55 and 65 years, is extremely debilitating.
Until recent years, pharmacological interventions have proven to be effective in delaying or mitigating many symptoms, but their efficacy fluctuates during the day and the dose needs to be increased with the condition’s progress.
Now, the movement issues associated Parkinson’s are being treated by Deep Brain Stimulation (DBS). This surgical intervention embeds an electrode in the brain and a subcutaneous battery just below the collarbone. The two communicate via cables and provide constant stimulation to the part of the brain responsible for the unwanted movements.
One of Australia’s most experienced DBS teams comprises neurologist Dr Thevathasan and Mr Bulluss: They undertake the procedure at several hospitals but do many at Cabrini, making it one of the largest centre for DBS in Australia.
The procedures run for four hours over three distinct phases:
- the first encompasses preparation during which parameters are measured and a temporary stereotactic head-brace is fitted
- then Mr Bulluss inserts the electrode into a very precise point in the brain while Dr Thevathasan navigates via imaging, records brain signals and monitors the awake patient
- finally the battery unit is inserted beneath the collarbone under general anaesthetic and the cables from the electrode are run below the skin down to the unit.
The procedure can be used to treat other disorders including essential tremor, dystonia and epilepsy, but is predominately used for Parkinson’s tremors. “DBS is not suitable for all Parkinson’s sufferers,” says Dr Thevathasan. “The patients to whom we offer it are generally under 75, have had a good response to medication and are cognitively reasonable.”
He and Mr Bulluss are deeply involved with research aimed at increasing the effectiveness and precision of the surgery. “We conduct research across all the hospitals in which we operate. This is great for our patients because we are always at the forefront of knowledge and can adopt new techniques very quickly,” said Dr Thevathasan.
These doctors are leading the field in many respects – they recently identified a biomarker which allows more precise implantation. Where precision of less than two millimetres is critical, this breakthrough is a game-changer. They are also working on a battery pack that responds to the patient’s activity level. Current batteries send a constant ‘on’ signal to the electrode which means that it runs at full pace 24 hours a day. The ability of the battery to modulate the stimulation in response to patient activity levels would mean enhanced patient experience and longer battery life. They are devising a battery unit for implantation behind the ear rather like the highly-successful Cochlear ear.
For more information about Cabrini's Parkinson's Program, visit: www.cabrini.com.au/patients-and-families/services/parkinson-s-program/about-our-parkinson-s-program/
For a referral to a Cabrini medical specialist, visit your GP. For information about Cabrini’s medical specialists, click on: www.cabrini.com.au/find-a-doctor