In Poland, Parkinson’s disease occurs in 100. people. Patients suffering from it do not need to stay at home. Thanks to innovative therapy, they can lead a normal life and be professionally active. The so-called Deep brain stimulation eliminates stiffness, tremors and restores the ability to move faster, thanks to which patients are in better condition, more efficient and fit.
The data show that in Poland already 100 suffer from Parkinson’s disease. people, but their number is constantly growing. They are treated with commonly available oral drugs containing levodopa, which is a precursor to dopamine and crosses the blood-brain barrier.
– At the beginning of the disease, it is easy for the patient to improve with these preparations, just as the condition of diabetic patients who require insulin is improved – said Dr. Magdalena Boczarska-Jedynak, a neurologist. People with Parkinson’s disease partially recover, can lead a normal life and continue working.
– The drugs stop working over time. Patients have to use increasingly higher doses, some patients instead of two or three times a day take them even 8-10 times to be able to function, because the therapeutic effect wears off after 60-90 minutes, and sometimes even faster – explained the specialist.
After 5, 10 or 15 years, patients usually stop responding to oral medications and require continuous dopaminergic stimulation. It is provided by new technologies, such as deep brain stimulation – DBS and the so-called infusion therapy.
– DBS is based on the fact that electrodes are implanted into specific structures of the brain, which, under the influence of electrical impulses, improve the patient’s efficiency – explained Dr. Boczarska-Jedynak. This method has been used in our country for 15 years.
Recently, we have available an enteral infusion of levodopa, which provides patients with a constant supply of dopamine, because the drug administered in this way is well absorbed and flows with the blood to the brain. The therapeutic effect of this method is similar, i.e. keeping the patient in better condition.
– There are two more methods that are not yet reimbursed in Poland – said the specialist. One is an apomorphic pump (subcutaneous infusion) and the other is rotinigotine in patches, which has a dopamine-like effect. When stuck to the skin, it also ensures a constant flow of the drug.
According to Dr. Boczarska-Jedynak, 10-20 percent are suitable for deep brain stimulation. patients with Parkinson’s disease. They cannot be over 70 years of age, and the disease must last at least 5 years, but not more than 15 years. Mental disorders, including depression, as well as dementia and serious comorbidities are contraindications.
The specialist argued that although deep stimulation is more expensive than traditional pharmacotherapy, it is profitable in the long run. – The costs of this therapy, compared to standard pharmacotherapy, increase by 32%. in the first year and are related to pacemaker implantation, but they decrease by 54%. in the following year and in each subsequent year they are smaller – she added.
DBS eliminates stiffness, tremors and restores the ability to move faster, thanks to which patients are in a better condition, more efficient and fit. Many of them can continue working.
According to Dr. Boczarska-Jedynak, it is more profitable to use the so-called two-channel stimulators for deep brain stimulation, because then it is enough to perform only one operation. – In the case of single-channel devices, in order to achieve a bilateral effect, the patient must undergo a second procedure and a second pacemaker implanted. And the cost of two procedures is higher than the cost of implanting one two-channel pacemaker – she argued.
The most important thing is to properly select patients for deep brain stimulation and to apply it at the optimal moment of the disease, not too early, but also when the patient’s daily functioning can be the most correct.
– Early surgery is a greater chance for the patient to extend his working capacity, as well as better economic and social aspects, including psychological ones, such as higher self-esteem and usefulness – emphasized Dr. Boczarska-Jedynak.
Parkinson’s disease is a growing civilization challenge. According to the data presented at the conference, 6,3 million people worldwide suffer from this disease, and 1,2 million in Europe alone. Deep brain stimulation helps already 140 thousand. sick.