Parkinson’s Disease
Parkinson’s disease is a degenerative brain disease associated with motor symptoms (slow movements, tremors, rigidity and disequilibrium) and with other complications, especially cognitive disorders, mental disorders, sleep disorders, pain and sensory disorders.
Motor impairments, such as dyskinesia (involuntary movements) and dystonia (painful involuntary muscle contractions) contribute to language disorders, mobility disorders and cause restrictions upon many aspects of everyday life. The progression of these symptoms causes heightened rates of disability and requirements in terms of care. Many people afflicted by this disease also develop dementia over the course of their illness.
Essential tremor
This genetic neurological disease makes up the majority of abnormal movements, with 1 out of 200 people afflicted, regardless of gender. It can appear as early as childhood and then get worse over time, thus causing a real handicap in simple everyday movements.
We currently do not know how to cure essential tremors, nor how to slow down their evolution, but there are treatments which allow to partially ease their symptoms, and thus better the patients’ quality of life.
If someone presents a great range of abnormal movements (> 1 centimeter in size/excursion), they will be offered deep-brain stimulation (DBS). It has been proven as a well effective treatment in this indication.
Dystonia
Dystonia results from muscular co-contractions either agonist, antagonist or synergistic, sustained, momentary or lasting ; they can generate abnormal postures or repetitive movements (tremors, myoclonus, athetosis,…). It can originate from monogenetism (in pure or mixed dystonia), genetic idiopatism, post-traumatic stress disorder, peripheral reasons (neurogenic lesions or CRPS) , post-anoxic reasons, post-encephalitis or post-stroke (in the case of later dystonia).
Several variants can be distinguished:
- Focal dystonia (blepharospasm, spasmodic torticollis, Writer’s cramp, spasmodic dysphonia), segmentary dystonia (limbs-related, trunk-related, cephalic;
- Permanent or paroxystic dystonia;
- Pure or mixed dystonia: myoclonic dystonia, spastic dystonia, ataxic dystonia…
- This disease comes with some specificities:
- Antagonist movements (which stops symptoms);
- Contextual specificity (musician, golfer, certain posture);
- An overflow (spread along a limb).
The resistant focal and generalized types can respond positively to pallidal deep-brain stimulation.
Other characteristics currently being studied
DBS is, in clinical research, tested for other pathologies: severe treatment-resistant depression, Gilles de la Tourette syndrome, obsessive-compulsive disorder (OCD), mental anorexia, certain forms of medically resistant epilepsy, cluster headaches, etc.
A pluridisciplinary decision for a variety of target areas
You will be selected at the end of an exhaustive pre-operation check-up performed by a pluridisciplinary team: neurosurgeons, neurologists, neuroradiologists, neuropsychologists, neurophysiologists, and psychiatrists, … It includes a motor-function appraisal, a neuro-cognition appraisal, an encephalic MRI, a psychiatry consult, and a study for infectious hotbeds. According to the pathology, the clinical signs, and your general state, electrodes will be implanted into specific cerebral areas: subthalamic nucleus (STN), internal globus pallidus, thalamus. Those zones are defined collegially by the pluridisciplinary team.