According to the Parkinson’s Foundation, more than 1 million people are currently living with the disease in the United States.
MAKENZIE O'KEEFE: Parkinson's Awareness Month. It's a time to spread the word about this disease but also a time to learn more about the treatments being offered. So joining me now is Dr. Matthew Mian, a functional neurosurgeon at Swedish Medical Center. And doctor, most people associate Parkinson's with tremors. But there's a lot more to the disease. So tell us a little bit about who does it affect and what should we all know about it.
MATTHEW MIAN: Thank you. So Parkinson's disease is actually very common. It affects something like 1% of people over the age of 65. And as you referenced, sometimes the most outward things that we notice or that lead to the diagnosis are things like the tremor. But actually, Parkinson's disease affects all parts of the body. Many times, in retrospect, patients have had problems long before their tremor becomes apparent. So problems with sleep, problems with the sense of smell, even constipation. But it's usually the movement related symptoms that gain attention and lead to a diagnosis. So the main symptoms we're thinking about are tremor, a slowness of movement, trouble with gait and balance, and stiffness or rigidity.
MAKENZIE O'KEEFE: Interesting. So as far as the diagnosis goes, some of the symptoms, is there a way to catch Parkinson's early or anything people need to be looking out for specifically?
MATTHEW MIAN: You know, a lot of the very early symptoms are unfortunately pretty non-specific. And so we usually don't make a diagnosis until a person starts to develop those movement symptoms that we talked about. Usually, Parkinson's disease is diagnosed by a neurologist with a formal neurologic examination. And unlike some other neurologic disorders, we don't actually have a formal test or scan that leads to diagnosis. It's mostly meeting a neurologist and having a detailed examination.
MAKENZIE O'KEEFE: Interesting. And you know, what kinds of treatments are there for this disease?
MATTHEW MIAN: So fundamentally, we think that Parkinson's disease relates to a loss of cells in the brain that produce a chemical called dopamine. And dopamine is what's called a neurotransmitter. It allows nerve cells to talk to each other. So the mainstay of our therapy for Parkinson's disease is trying to replace that dopamine with medications, with pills. For patients who have been on medications for some time and lose effectiveness of the medicines or start to have problems with the medications, we think about a different category of treatment. And that's something called deep brain stimulation.
MAKENZIE O'KEEFE: Great. Tell us a little bit more about that and how that's different than other treatments that are out there.
MATTHEW MIAN: Yeah. So deep brain stimulation or what we call DBS for short is a procedure that we've had in the United States for about 25 years. I compare it to a pacemaker for the brain. So it consists of a thin wire that enters the brain and is connected to a small battery pack that sits underneath the collarbone. And the device is constantly working, delivering very targeted pulses of electricity to a part of the brain that we know is dysfunctional in Parkinson's disease. And what this does is translate into a very dramatic change in a patient's movement related symptoms. So their movements become more fluid, their tremor is much better controlled, and they often have much less need for the medications that we use to replace dopamine.
MAKENZIE O'KEEFE: Wow. That is just incredible. Can deep brain stimulation help with other conditions besides Parkinson's? Or is it just for Parkinson's that this works?
MATTHEW MIAN: Yeah. So we now use deep brain stimulation for several different neurologic disorders. Parkinson's disease is probably the most common. But deep brain stimulation applied to a slightly different part of the brain is very effective for patients with a disorder called essential tremor, which is really exaggerated tremor that can affect everyday activities like writing or eating or drinking. And increasingly, we're starting to use deep brain stimulation for epilepsy, for patients with seizures.
MAKENZIE O'KEEFE: Wow. It's just fascinating. When was this type of treatment developed or mainstreamed for Parkinson's and other conditions?
MATTHEW MIAN: So the research into deep brain stimulation really caught fire in the 1970s and '80s. And then it was adopted in clinical use in the United States in the late 1990s and the early 2000s. So as I mentioned, we've been doing this for about 20 years. Nowadays, it has really evolved into the standard of care for patients with advanced Parkinson's disease. And it's used in centers throughout the country. There have been hundreds of thousands of patients who've been implanted with a DBS system.
We used to do a related therapy where instead of placing a stimulator, we would burn a small spot in the brain, create what's called a lesion. That is the procedure that Michael J. Fox had, for example. But we learned over time that if we placed the stimulator instead, there were certain advantages. We can turn the therapy up or down as a patient's symptoms changed over time. And the therapy fundamentally is safer and reversible if needed.
MAKENZIE O'KEEFE: Wow. Very interesting. Thanks so much for all this information, Dr. Mian. We really appreciate it.
MATTHEW MIAN: My pleasure.
MAKENZIE O'KEEFE: And for more Parkinson's resources, you can head over to our website, CBSDenver.com.