If you are an unfortunate Parkinson’s patient, we would now like to introduce you to a new treatment that may allow you to escape your current situation and be free of the disease for at least a few years. You can regain your ability to eat, drink, dress and write on your own, and you can resume your normal social activities, go on outings, picnics, parties and enjoy life to the fullest – a new treatment – the Activa Motion Control Therapy, or Pacemaker for short, offers you a new treatment option.
Pacemakers, also known as Deep Brain Stimulation (DBS), were used for pain control in the 1960s, and clinical studies on deep brain stimulation for Parkinson’s disease began in Europe in 1987, and have been used in Europe and the United States since the mid- to late-1990s. The brain pacemaker has been described as another milestone in the treatment of Parkinson’s disease after levodopa. It has been designated as an effective treatment option for Parkinson’s disease by the U.S. government.
The brain pacemaker is the biggest breakthrough in Parkinson’s disease treatment in the last 30 years. The symptoms of Parkinson’s disease are found as a result of decreased production of dopamine by nigrostriatal nerve cells in the brain. Dopamine is a neurotransmitter through which structures in the brain associated with movement transmit information. It controls the movement of the body.
Due to the decrease in dopamine, some structures in the brain associated with movement (nucleus accumbens, pallidum) are overexcited and transmit abnormal signals, producing the symptoms of Parkinson’s disease. The implanted pacemaker delivers weak electrical impulses to stimulate the nuclei that control movement in the brain and suppress the abnormal brain signals that cause Parkinson’s disease symptoms, thus eliminating the symptoms of Parkinson’s disease and restoring the patient’s ability to move freely and care for himself or herself.
The pacemaker is a compact microelectronic device consisting of a pulse generator, an electrode and an extension lead, all of which are implanted in the body. The implanted components do not interfere with the patient’s daily life.
Indications
Brain pacemakers are indicated for.
1. primary Parkinson’s disease
2. When levodopa has been used with good results
3. The drug has gradually failed or side effects have appeared
4. The disease has begun to seriously affect normal working life
5, no obvious intellectual impairment
6. Willing and able to cooperate in the implantation process and subsequent follow-ups
7. Intraoperative or postoperative test stimulation can effectively control the symptoms
You can consult your specialist about your suitability for pacemaker therapy.
Clinical results
Since the mid to late 1990s, tens of thousands of Parkinson’s disease patients worldwide have been able to start a new life with the help of pacemakers, with long-term stable results: 1.
1. Control of the main symptoms of Parkinson’s disease: tremors, rigidity, slow or inability to move, balance disorders, etc..
2.Reducing the dose of drugs;
3, eliminate or reduce the side effects caused by drugs;
4.Increase the time of “on” period, improve the quality of life of “off” period, and improve the ability of daily activities;
5.As far as possible, according to the needs of patients, non-invasive adjustments can be made in vitro to control the symptoms for a long time;
6. Bilateral simultaneous implants can be used to control bilateral symptoms, especially midline symptoms such as rising, stepping, turning and rolling.
Foreign brain pacemaker therapy has been used from the initial use in patients with advanced Parkinson’s disease, where drugs have completely failed, to now, patients with Parkinson’s disease receive brain pacemaker therapy when they cannot maintain normal work life and social activities. After years of global multicenter clinical studies, it has been found that brain pacemaker therapy slows the progression of Parkinson’s disease in some patients, and further long-term observation is underway.
Pacemaker therapy was introduced into China in 1999, and has been carried out in several medical centers in China, and considerable clinical experience has been accumulated.
Pacemaker surgery procedure
With the help of precise stereotactic surgery, the pacemaker can be implanted smoothly. This procedure is safe, less traumatic, does not destroy brain tissue, and avoids irreversible and serious complications caused by the destruction of neural clusters.
The installation process can be basically divided into the following steps.
I. Installation of the stereotactic head frame The stereotactic head frame helps the neurosurgeon to accurately position the electrodes to be placed. This procedure is performed under local anesthesia, and there is generally no significant discomfort except for a mild feeling of pressure.
Precise positioning The position of the head is checked by CT or magnetic resonance imaging (MRI) and, as needed, helps the surgeon to obtain positioning data for the area where the pacemaker needs to be implanted.
The electrode is inserted into the brain with a needle-thin electrode after a hole the size of a penny is made in the top of the patient’s head to locate the stimulation site according to the previous positioning.
After implanting the electrodes, the doctor will conduct a preliminary test. The patient will be asked to do some simple movements, such as holding a cup, stretching the arm, drawing a spiral, etc. Then, according to the patient’s feeling and the degree of improvement of symptoms, the position of the electrode and the intensity of stimulation will be further adjusted to obtain the best effect.
If the symptoms are controlled during the test, the doctor can further implant the entire pacemaker system. This procedure can be performed immediately or after several days of observation. This is done by implanting a pulse generator under the skin of the chest and connecting the generator to the electrodes via a wire under the skin.
Related matters
Patients with Parkinson’s disease can ask their doctor about the efficacy of the brain pacemaker and the procedure before the surgery. During the procedure, the patient is awake most of the time, as the patient’s cooperation is needed to determine the placement of the electrodes and the effectiveness of the treatment. For pacemaker users, post-surgical follow-up is very important.
After the wound has healed, the surgeon regulates the pulse generator outside the body using computer telemetry, a process called program control. This is a non-invasive and painless procedure. Program control may be performed several times in the months following surgery.
Repeated program control helps patients achieve optimal symptom control. Subsequent follow-up visits may be made 1-3 times a year for appropriate testing and programming.
The pacemaker has a small remote magnet switch. To use the pacemaker, the hand holds the curved end of the magnet so that the flat end is facing the body, and the magnet is placed in the chest pulse generator position for 1 second, and the pacemaker starts or stops working.
Strenuous activity should be avoided for several weeks after the pacemaker implantation.
Since magnets can affect the memory information of magnetic tapes, computer disks, credit cards, etc., it is recommended to stay more than 15 cm away from these items when using magnets. Although household appliances, computers and telephones have no effect on the system, magnetic fields in refrigerator doors and stereo speakers may affect the proper functioning of the pacemaker, so patients are advised not to get too close. Patients should avoid therapeutic ultrasound, short-wave, and microwave therapy after surgery. Patients should consult their surgeon if they want to undergo special tests such as magnetic resonance imaging (MRI) and ultrasound.
Each patient is given an implant identification card after surgery to prove the presence of the pacemaker system in your body and it is recommended that you carry the card with you at all times. The pulse generator in the pacemaker may cause alarms at airport security gates and mall security doors, and it is recommended to use the implant identification card for assistance.
The battery of a pacemaker system usually lasts about 4 to 5 years. If the battery is depleted, the pulse generator needs to be replaced, the electrodes and leads do not need to be replaced. This can be replaced with a simple surgical procedure.
Side effects and surgical complications of brain pacemakers
Pacemakers are a new type of treatment, and their high degree of safety is a major advantage. There are very few permanent side effects, and very few patients may feel a loss of muscle strength in the limbs, a decrease in the pitch of speech, transient dizziness and transient numbness, which can be reduced or eliminated by extracorporeal programming if they occur.