A comprehensive treatment program improves Parkinson’s patients

Parkinson’s is a chronic, progressive disease in which motor symptoms predominate, such as bradykinesia (slowness of movement), tremor and muscle rigidity. In the initial stages, oral treatment with different drugs effectively controls these symptoms, but within 5 years, in half of the cases, and within 10 years, in almost 100% of the patients, this type of therapy is not sufficient. It is at this point that being able to offer a comprehensive treatment program becomes especially important.

The comprehensive therapeutic program allows faster access and with less delay to the different highly complex treatments, thus significantly improving the quality of life of people with Parkinson’s. “Experience has shown us that having neurologists, neurosurgeons, neurophysiologists, neuropsychologists, speech therapists, dieticians, physiotherapists and rehabilitation physicians in the same centre is very positive in the treatment of patients with complicated Parkinson’s disease,” explains Dr. Matilde Calopa, head of the Parkinson’s and Abnormal Movement Unit at Bellvitge University Hospital (HUB). This comprehensive assessment makes it possible to offer patients the most appropriate therapy in the advanced stages.

One of these treatments is deep brain stimulation, a surgical operation that consists of implanting brain electrodes in abnormally active areas of the brain in Parkinson’s patients. The technique allows neuromodulation of the motor circuit of the basal ganglia in some of its critical nodes. The points to be stimulated can be the thalamus, the internal pale nucleus or the subthalamic nucleus. “At Bellvitge University Hospital we prefer to stimulate the subthalamic nucleus, as it has the same beneficial effects and at the same time allows medication to be reduced by less than half, in some cases,” says Dr. Gerard Plans, neurosurgeon at Bellvitge Hospital. Deep brain stimulation results in a significant overall improvement of 80% of the motor symptoms of Parkinson’s, such as motor fluctuations, severe ‘off’ (very poor mobility) and dyskinesias (involuntary movements) present in many patients in an advanced stage of the disease.

On the other hand, continuous infusion systems have become established as one of the most effective treatments when other therapies do not work in seriously ill patients. “This method, which consists of the continuous administration of a levodopa and carbidopa gel through the intestine, corrects motor fluctuations and dyskinesias, reduces absorption problems, allows the dose to be adjusted according to the patient’s needs and improves autonomy and, thus, the person’s quality of life,” explains Dr. Serge Jaumà, a neurologist at Bellvitge University Hospital. The procedure consists of performing an endoscopic percutaneous gastrostomy, to place a permanent catheter that passes through the stomach to the duodenum, where it remains fixed. This internal tube is connected by an external tube to a portable infusion pump that continuously releases the individually programmed dose for each patient.

At this time, research and clinical trials being carried out in specialized hospitals are essential in the fight against the manifestations of Parkinson’s disease. “At Bellvitge Hospital, we are researching the duration of the beneficial effects of drugs, the most appropriate form of administration, as well as the creation of specific medication for each phase of the disease,” says Dr. Matilde Calopa. The existing lines of research to achieve progress in reducing the symptoms of this pathology are key to continuing to work on improving the quality of life of these patients.

Bellvitge University Hospital (HUB)

Bellvitge University Hospital (HUB) belongs to the Catalan Institute of Health (ICS) and is one of the 5 large university hospitals in Catalonia, registering 30,700 annual discharges, of which 34.9% are of high complexity. It is the tertiary reference hospital for the entire southern axis of Catalonia up to the Ebro regions, which means healthcare coverage for more than 2 million inhabitants. It has been TOP 20 in the ranking of the best Spanish hospitals consecutively for the last four years.

Source Hospital Universitario de Bellvitge (HUB)