Our Summary

This research investigates the effectiveness and safety of a specific type of surgery for Parkinson’s disease patients, where electrical stimulation is delivered to a part of the brain called the subthalamic nucleus. The study compares two methods of the procedure: one where patients are put to sleep with general anesthesia and another where patients stay awake under local anesthesia.

60 patients participated in the study, half of whom were put to sleep for the surgery while the other half stayed awake. Various techniques and tools were used during the surgery to ensure accuracy, monitor the depth of anesthesia, and assess the improvement of patients’ motor symptoms before and after the operation.

The results showed that all surgeries were successfully completed, with the electrodes accurately placed in the right position. There was no significant difference in the improvement of motor symptoms between the patients who were put to sleep and those who stayed awake. There were also no severe complications like brain bleeding, stroke, or infection after the operation. However, 5 patients experienced temporary mental and behavioral changes, which resolved within 48 hours after the operation.

In conclusion, the study suggests that putting patients to sleep during this type of surgery for Parkinson’s disease is as effective as the traditional method where patients stay awake. Furthermore, when performed under strict control, the risk of complications related to the surgery and anesthesia is low. Patients also reported improved comfort during the surgery.

FAQs

  1. What is the specific type of surgery for Parkinson’s disease that the research investigates?
  2. Was there any difference in the improvement of motor symptoms between the patients who were put to sleep and those who stayed awake during the surgery?
  3. What complications were observed after the operation and how were they managed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about brain surgery is to follow all pre-operative instructions provided by the medical team, such as fasting before the procedure and avoiding certain medications. It is also important to have a clear understanding of the risks and benefits of the surgery, as well as any potential side effects or complications that may arise. Additionally, following post-operative care instructions, such as taking prescribed medications and attending follow-up appointments, is crucial for a successful recovery. It is important to communicate openly with your healthcare team and ask any questions or voice any concerns you may have throughout the process.

Suitable For

Patients with Parkinson’s disease who are experiencing motor symptoms that are not well controlled with medication are typically recommended for brain surgery like deep brain stimulation of the subthalamic nucleus. This procedure is often considered for patients who have been diagnosed with Parkinson’s disease for a number of years and have developed complications from their medication, such as dyskinesias or motor fluctuations. Patients who are relatively young and healthy, and who do not have significant cognitive impairment or other medical conditions that would increase the risks of surgery, may be good candidates for this type of intervention.

It is important for patients to undergo a comprehensive evaluation by a multidisciplinary team, including movement disorder specialists, neurosurgeons, neuropsychologists, and other healthcare providers, to determine if brain surgery is the best treatment option for them. The decision to undergo surgery should be made on a case-by-case basis, weighing the potential benefits of improved symptom control and quality of life against the risks of surgery and potential complications.

Timeline

Before brain surgery:

  • Patient meets with neurosurgeon and medical team to discuss surgical options and risks
  • Patient undergoes pre-operative testing to ensure they are a suitable candidate for surgery
  • Patient may need to adjust medications and follow specific pre-operative instructions
  • Patient is admitted to the hospital on the day of surgery

After brain surgery:

  • Patient wakes up in the recovery room and is monitored closely for any immediate complications
  • Patient may experience pain, fatigue, and confusion in the initial days after surgery
  • Patient may need to stay in the hospital for a few days for observation and post-operative care
  • Patient will have follow-up appointments with the medical team to monitor their progress and adjust treatment as needed
  • Patient will undergo rehabilitation and physical therapy to help regain strength and function
  • Patient may experience improvements in symptoms related to their condition after the surgery, but recovery time and outcomes vary for each individual.

What to Ask Your Doctor

Some questions a patient should ask their doctor about brain surgery for Parkinson’s disease include:

  1. What are the potential risks and complications associated with this type of surgery?
  2. How will the surgery be performed, and what techniques/tools will be used to ensure accuracy and safety?
  3. What criteria should I meet to be a suitable candidate for this surgery?
  4. What is the expected outcome and improvement in motor symptoms after the surgery?
  5. How long is the recovery process, and what kind of post-operative care will be required?
  6. Will I need to undergo any additional treatments or therapies after the surgery?
  7. How will my pain and discomfort be managed during and after the surgery?
  8. Are there any long-term effects or risks associated with this type of surgery?
  9. What kind of follow-up care and monitoring will be necessary after the surgery?
  10. Are there any alternative treatment options available for Parkinson’s disease that I should consider before opting for surgery?

Reference

Authors: Shi YF, Zhang Y, Li P. Journal: Sichuan Da Xue Xue Bao Yi Xue Ban. 2022 Jul;53(4):583-587. doi: 10.12182/20220760502. PMID: 35871727