Thin electrical catheters, directed and monitored by the operator, represent the new frontier for the management of Parkinson’s. The therapy is used in Deep Brain Stimulation (DBS), the surgical treatment that has shown excellent results over the last twenty years in controlling motor symptoms and improving the person’s clinical picture in general.
Directional leads appear as extremely fine (0.5 to 1.5 mm) electrical wires. They are implanted under local anesthesia on carefully selected patients and work together with a small neurostimulator, similar to a pacemaker, which sends electrical signals to the area of the brain correlated with Parkinson’s symptoms.
Thanks to the possibility of directing the impulses, the therapy uses very precisely the ability to modulate the stimulation based on the need, thanks to sensing, or the monitoring of brain activity.
The advantages of this new treatment of the disease are offered by the possibility of having individual and specific data of the patient, monitored by the operator on a computer in detail, to allow a truly personalized therapy capable of improving the quality of life of the person.
Studies on the application of directional leads have shown that deep brain stimulation performed is effective in controlling essential tremor, dystonia and Parkinson’s disease symptoms that cannot be adequately controlled by drug therapy.
To be able to undergo this treatment “patients must have a confirmed diagnosis of ‘decompensated’ Parkinson’s disease – says Professor Andrea Landi, of the UO Pediatric Neurosurgery, Hospital of the University of Padua, who performed the first surgery in Italy – that is, no longer manageable with pharmacological treatment alone, they must not have psychiatric disorders and lesions in the pre-implantation brain resonance examination. The operation is indicated for patients up to 70 years of age “.
“The advantages – continues Professor Landi – are evident after the implant, following which the patients have a good control of the main symptoms of the disease such as tremor, rigidity, slowness of movements (bradykinesia); fluctuations also improve considerably and dyskinesias due to drugs (in particular levodopa). Finally, there is also an improvement in mood, sleep-wake rhythm and gait. For this reason, medical therapy can generally be reduced “.
To date, in addition to the Padua Hospital, the facilities where the directional lead has been successfully implanted are: the University Hospital of Siena; the “S. Salvatore ”of L’Aquila; the IRCCS Institute of Neurological Sciences of Bologna, the ASST Papa Giovanni XXIII of Bergamo; the Major AOU of Charity of Novara; the IRCCS Galeazzi Orthopedic Institute of Milan and IRCCS Mondino Foundation of Pavia.