Parkinson’s, directional leads for personalized therapy

Thin electrical catheters, directed and monitored by the operator, represent the new frontier for the management of Parkinson’s. The therapy is used in Deep Brain Stimulation (DBS), the surgical treatment that has shown excellent results over the last twenty years in controlling motor symptoms and improving the person’s clinical picture in general. Directional leads appear as extremely fine (0.5 to 1.5 mm) electrical wires. They are implanted under local anesthesia on carefully selected patients and work together with a small neurostimulator, similar to a pacemaker, which sends electrical signals to the area of ​​the brain correlated with Parkinson’s symptoms. Thanks to the possibility of directing impulses, the therapy uses the ability to modulate stimulation based on need with great precision, thanks to sensing, or the monitoring of brain activity. The advantages of this new treatment of the disease are offered by the possibility of having individual and specific data of the patient, monitored by the operator on a computer in detail, to allow a truly personalized therapy capable of improving the quality of life of the person. Studies on the application of directional leads have shown that deep brain stimulation performed is effective in controlling essential tremor, dystonia and Parkinson’s disease symptoms that cannot be adequately controlled by drug therapy. To be able to undergo this treatment “patients must have a confirmed diagnosis of ‘decompensated’ Parkinson’s disease – says Professor Andrea Landi, of the Pediatric Neurosurgery Unit, University of Padua Hospital, which performed the first surgery in Italy – that is, no longer manageable with pharmacological treatment alone, they must not have psychiatric disorders and lesions in the pre-implantation brain resonance examination. The intervention is indicated for patients up to 70 years of age “. Landi – are evident after implantation as a result of which patients have good control of the main symptoms of the disease such as tremor, rigidity, slowness of movement (bradykinesia); fluctuations and dyskinesias due to drugs also greatly improve ( in particular to levodopa). Finally, there is also an improvement in mood, sleep-wake rhythm and walking. medical therapy can be reduced “. To date, in addition to the Padua Hospital, the facilities where the directional lead has been successfully implanted are: the University Hospital of Siena; the “S. Salvatore ”of L’Aquila; the IRCCS Institute of Neurological Sciences of Bologna, the ASST Papa Giovanni XXIII of Bergamo; the Major AOU of Charity of Novara; the IRCCS Galeazzi Orthopedic Institute of Milan and IRCCS Mondino Foundation of Pavia.