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NY Methodist’s Parkinson’s Disease Program: a Team Approach

December 18, 2012 Editorial Staff

Photo courtesy of NY Methodist.

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Parkinson’s disease (PD) is one of the most common neurological disorders — each year, over 50,000 Americans are diagnosed with the condition. PD is a chronic disease; once symptoms appear, they can be treated but will not disappear entirely. Over 90 percent of PD cases occur in those aged 50 and over, making the disease a major threat to the quality “golden years” a senior deserves.

PD is a disorder of the central nervous system involving the degeneration and loss of nerve cells in a key area of the brain. The most characteristic feature of Parkinson’s is a slow and rhythmic tremor when the body is at rest. There are many other common symptoms of PD, but there is no way of knowing which ones a patient will have, or in what order they may occur. Parkinson’s usually progresses slowly, but the rate of progression varies from one individual to another.

New York Methodist Hospital’s (NYM’s) Parkinson’s Disease Program offers the only comprehensive diagnostic and treatment program in Brooklyn for Parkinson’s and other movement disorders. The Program utilizes a team approach, engaging the skills of neurologists, neurosurgeons, speech pathologists, mental health professionals, nurses and rehabilitation therapists.

“With each patient, we create a unique treatment regimen that addresses symptoms,” says Miran Salgado, M.D., Chairman of Neurosciences and director of the Parkinson’s Disease Program at NYM. “We fine-tune medicine regimens and use rehabilitation therapies including physical therapy, dietary modification and exercise to help fight the progression of PD.”

Perhaps the most effective medicine used to treat Parkinson’s Disease is Levodopa, which converts to dopamine in the brain. Increased dopamine helps reduce many PD symptoms, including tremor, stiffness, imbalance, and lack of muscle control. Levodopa is often taken in conjunction with other medications that increase its efficacy while limiting side effects. In many cases, however, medications will have a stronger impact at the beginning of the treatment, and will need to be increased or modified over time.

“Sometimes, PD medications have limited effects on the symptoms of the disease, and in fact, the medications may result in significant side-effects,” says Martin Zonenshayn, M.D., chief of neurosurgery at NYM. “When this happens, surgeons can perform an advanced, minimally invasive procedure in which a pair of electrodes is inserted through a small opening in the skull. The electrodes are placed within key areas of the brain affected by PD, and then connected by implanted wires to a device called an implanted pulse generator (IPD – more commonly known as a ‘brain pacemaker’).

“Once activated, an IPD sends continuous electrical pulses to the target areas in the brain, blocking the impulses that cause tremors and other PD symptoms,” continued Zonenshayn. “This form of treatment is called Deep Brain Stimulation (DBS), and the activation is controlled entirely by the patient and physician using a hand-held remote control device. The true advantage of this surgery is that the stimulation is adjustable and reversible for years after the original surgery, thereby allowing the physician to make the necessary adjustments as the disease evolves.”

Each PD patient faces unique symptoms, and NYM’s Parkinson’s Disease Program will help him or her address these symptoms as effectively as possible. For more information about the Parkinson’s Disease Program at New York Methodist Hospital, call 718.264.8820.