Recommendation for using deep brain stimulation in early stage Parkinson's disease
Ho, Arthur Yau Wing
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Parkinson's disease is a progressively debilitating disease that affects about 1% of the world's population, and does not differentiate between genders or races. The disease is caused by the death of the dopaminergic neurons in the basal ganglia nuclei, especially those in the substantia nigra pars compacta. Subsequent loss of dopamine production engenders the cardinal symptoms of bradykinesia, rigidity, akinesia, and postural instability found in all patients with Parkinson's disease. While there are several types of Parkinson's disease, the majority of the cases are made up of the idiopathic and Levodopa responsive type. The current consensus on treatment is to use medications until the patient becomes refractory to all medicines. It is only at this point will the surgical option deep brain stimulation be considered. while this procedure comes with a higher risk of post surgery complications, the benefits it offers patients with advanced Parkinson's disease are far superior to those offered patients by medications. It reasons then that patients would benefit more if they received this treatment earlier in the course of the disease. The mechanisms, side effects, costs, cost-effectiveness, and long term effects on quality of life of deep brain stimulation will be compared with those of medications to assess whether it is worthwhile to use this treatment for patients with mild Parkinson's disease.
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