Deep Brain Stimulation Effectiveness in Parkinson's Disease PDF

THE EFFECTIVENESS OF DEEP BRAIN STIMULATION IN TREATING PARKINSON’S DISEASE GROUP 20 AUTHORS: Alex Achtypis, Amelie Sommergyll, Diyar Demir, Maarun Nackeeran, and Shania Kadir BACKGROUND...

THE EFFECTIVENESS OF DEEP BRAIN STIMULATION IN TREATING PARKINSON’S DISEASE GROUP 20 AUTHORS: Alex Achtypis, Amelie Sommergyll, Diyar Demir, Maarun Nackeeran, and Shania Kadir BACKGROUND DEEP BRAIN STIMULATION Deep brain stimulation (DBS) is a surgical treatment for Parkinson’s 1. MRIPROCESS scan used to identify treatment areas in the brain -usually the disease to reduce severity of symptoms. It involves electrode implantations subthalamic nucleus (STN) and globus pallidus(GPi) -which are hyperactive in specific areas in the brain to regulate abnormal brain activity. (Bronstein and causing the motor symptoms due to dopamine loss. J. et al, 2011) 2. Electrodes are placed in the target areas and connected to Parkinson's disease (PD) is a progressive neurological brain disorder a neurostimulator which is inserted in the sub clavicular area (below the caused by the loss of dopamine-producing neurons affecting movement. collar bone). (Beitz J., 2014) 3. The neurostimulator then generates electrical impulses to regulate irregular impulses produced by the target regions. (B.Pharm, 2015) What can improve results? The aims are to outline the process of DBS and the causes of PD, as well Adaptive DBS (aDBS) produces electrical signals based on brain activity, to Figure 1 as evaluating its effectiveness in treating PD avoid disruption to normal brain activity (Beudel and Brown, 2016). Diagram showing electrode placement Frequency, amplitude and wavelength of the neurostimulator can be adjusted CAUSES OF PARKINSON'S DISEASE (B.Pharm, 2015) to suit the needs of each individual. Graphs Higher frequency showing tends to have variations the best of bradykinesi α -synuclein (SNCA) (Costa H. et al, 2023) results DBS: POSITIVES VS NEGATIVES for patients. (Moro et al., 2002) Figure 2 (Moro Mutations of SNCA protein causes the aggregation of et al., 2002) POSITIVES misfolded α -synuclein in neurons which leads forms Lewy o Reduces essential tremors: help alleviate motor Bodies symptoms (e.g. tremors, rigidity, bradykinesia, Excessive levels of Lewy Bodies is toxic to the dopamine- dyskinesia) secreting neurons o Long-term solution: medications will wear off over PINK1 & PARKIN (Knight E. et al, 2022) time, whereas DBS will not Promotes mitophagy & plays role in mitochondrial function o Reversible: if DBS is not suitable to patient, the Gene dysfunction damages the mitochondria leading to NEGATIVES components (Beudel can beMremoved & Brownvia P, 2016) surgery Increased Amplitude Increased FrequencyIncreased Wavelengt oxidative stress o Surgical risks: infections, bleeding, complications The buildup of damaged mitochondria leads to cell death in CONCLUSION from anesthesia, extensive hospitalization the neurons o Non- rechargeable batteries requires more Overall, DBS appears as the most effective long-term Gut dysbiosis (Akbar M. et al, 2024) treatment for Parkinson's Disease, especially for patients surgeries to replace batteries of pulse generator An imbalanced gut microbiome is shown to affect motor that no longer respond to other medications. However, DBS o Paradoxical effects: constant production of electrical is not a cure as it only alleviates the symptoms and does functions signals by pulse generator can disrupt normal brain Elevated gram-negative bacteria is related to postural not stop the progression of PD. When used alongside activity other potential treatments such as VR therapy and stem unsteadiness, which is linked to higher level of o Change Does not in cure mean Parkinson’s UPDRS III off Disease Medications cells, the progression of Parkinson's disease can be slowed lipopolysaccharides RISK FACTORS OF andPD endotoxins resulting in intestinal ALTERNATIVE TREATMENTSfollowing DBS providing a better quality of life for patients. Further 1)inflammation Age: >60 years MEDICATIONS research is needed to improve the effectiveness of DBS in 2) Gender: males are 1.5-2 the treatment of Parkinson’s disease. Akbar, M., Toppo, P., Nazir, A., (2024) ‘Ageing, proteostasis, and the gut: Insights into neurological health and THERAPIES -MAO-B -Physical disease’, Ageing Research Reviews, 101, (November). Available at: https://doi.org/10.1016/j.arr.2024.102504 (Accessed: 31 October 2024)​ times higher at risk compared Beudel, M., Brown, P., (2016) ‘Adaptive deep brain stimulation in Parkinson’s disease’, Parkinsonism & -Levodopa therapy Related Disorders, 22, pp. 123-126. Available at: https://doi.org/10.1016/j.parkreldis.2015.09.028 (Accessed: to females -Catechol-o- 31 October 2024) ​ 3) Head injuries: Traumatic -Occupational Clinical Effectiveness of DBS for Parkinson’s Disease. (2017). Available at: methyltransferase therapy https://www.bostonscientific.com/en-EU/health-conditions/parkinson-s-disease/Clinical-Data.html [Accessed 16 Nov. 2024]. ​ Brain Injury (TBI) increases risk inhibitors Gray, R., Patel, S., Ives, N., Rick, C., Woolley, R., Muzerengi, S., Gray A., Jenkinson, C., McIntosh, E., Wheatley, -Speech K., Williams, A., Clarke, C.E., (2021) ‘Long-term Effectiveness of Adjuvant Treatment With Catechol-O- of Parkinson’s Methyltransferase or Monoamine Oxidase B Inhibitors Compared With Dopamine Agonists Among Patients (Gray, R. FUTURE therapy TREATMENTS: Figure 3 With Parkinson Disease Uncontrolled by Levodopa Therapy’, JAMA Neurology, 79(2), (February), pp. 131-140. 4) Environmental: pesticides, et al, VR therapy, stem cell (Clinical Effectiveness of DBS for Available at: https://doi:10.1001/jamaneurol.2021.4736 (Accessed: 31 October 2024)​ Parkinson's Disease, 2017) Moro, E., Esselink, R.J.A., Xie, J., Hommel, M., Benabid, A.L., Pollak, P., (2002) ‘The impact on Parkinson’s heavy metals, pollutants 2021) therapy disease of electrical parameter settings in STN stimulation’, Neurology , 59(5), (September), pp. 706 – 713.