Brain Surgery First For Flinders
First Published: Investigator - June 2009
Flinders Medical Centre is the first hospital in South Australia to successfully improve the symptoms of people with Parkinson’s disease and other movement disorders by using ‘deep brain stimulation’ (DBS).
The comprehensive DBS program is being developed in South Australia by Head of Neurology at Flinders Medical Centre Associate Professor Dominic Thyagarajan and Neurosurgeon Matthew McDonald.
The four hour technique involves drilling one or two small holes into the skull under local anaesthetic while the patient is fully awake.
A fine wire (electrode) is inserted deep into selected targets in the brain involved in the control of movement, the most common target being the sub thalamic nucleus (STN). In Parkinson’s disease, the STN is over-active.
Once the wire has been placed in its exact position in the brain, it is led behind the neck (under the skin) and connected to a pacemaker device below the collar bone.
The pacemaker device is used to send electrical impulses to the tip of the electrode and stimulate the over-active STN at high frequency.
‘One theory is that the high frequency of the current shuts down the abnormal firing pattern of the STN in Parkinson’s disease,’ Associate Professor Thyagarajan said.
‘Blocking or interfering with the abnormal STN improves the motor symptoms of Parkinson’s and reduces involuntary movements produced by medication.’
Associate Professor Thyagarajan said the technique may be suitable for people with advanced Parkinson’s disease, or for those in whom medication is not working effectively.
‘Whilst this procedure significantly improves symptom control, there is still no cure for Parkinson’s disease,’ he said.
‘This technique often reduces the need for medication which can cost thousands of dollars each year for some patients.’
Deep brain stimulation is not appropriate for all patients with movement disorders. It has been used successfully in Europe since 1987 for other conditions such as depression, Tourette’s syndrome, epilepsy and chronic pain. The procedure is also available in Brisbane, Sydney and Melbourne hospitals.