There is still no cure for Parkinson’s disease, but effective treatments are available to manage symptoms and delay its debilitating effects. Over the years, significant advances have been made in treatment, particularly in surgical interventions. Discussing the modern surgical approach to Parkinson’s disease, its symptoms, and disease progression at the Guwahati Press Club on Saturday was Dr. Sathwik R Shetty, Neurosurgeon at Manipal Hospital, Bengaluru.
Nearly 10 million people worldwide are living with Parkinson’s disease, while in India the number is estimated at 500,000 to 600,000. It is a progressive neurological disorder that often begins with tremors in the hands or legs and gradually affects movement, mobility, and quality of life. Although medication remains the primary form of treatment, many patients experience worsening symptoms and increased drug-related side effects as the disease advances. Medications are generally effective for about four to five years. After that, Deep Brain Stimulation (DBS) has emerged as an effective treatment option for patients with advanced Parkinson’s disease.
Dr. Shetty explained that DBS has helped many patients regain better mobility, reduce their dependence on medication, and significantly improve their overall quality of life.
“DBS does not cure Parkinson’s disease, but it can substantially reduce motor symptoms such as tremors, rigidity, and slowed movement. In many cases, it also allows patients to reduce their medication dosage, thereby minimizing medication-related side effects,” he said.
He explained that the procedure involves implanting fine electrodes in specific areas of the brain. These electrodes are connected to a battery-powered pulse generator placed beneath the skin in the chest. The device delivers continuous electrical stimulation that helps regulate abnormal brain signals caused by dopamine deficiency, resulting in smoother and more controlled movement. While the batteries in earlier pulse generators needed replacement every five years, modern rechargeable batteries can last up to fifteen years.
In the weeks following surgery, neurologists gradually adjust the stimulation settings and modify medication doses as needed to achieve the best possible outcomes for patients.
Dr. Shetty emphasized that proper patient selection is critical to the success of DBS. The procedure is generally recommended for individuals who have been living with Parkinson’s disease for at least five years and who continue to respond to medication but require increasingly frequent dose adjustments. Higher medication doses often lead to severe side effects such as dyskinesia, characterized by uncontrolled involuntary movements. These patients are typically the ones who benefit most from DBS.
Before surgery, patients undergo a comprehensive evaluation by a multidisciplinary team comprising neurologists, neurosurgeons, psychiatrists, neuroradiologists, and anesthetists. Following the procedure, patients remain under regular follow-up care from both neurosurgeons and neurologists. Most patients are discharged from the hospital within five days.
According to Dr. Shetty, Parkinson’s disease is most commonly seen in people over the age of sixty, although its exact cause remains unclear. Genetic factors are believed to account for 15 to 20 percent of cases. Exposure to pesticides and environmental pollution may increase the risk, particularly among agricultural workers, tea garden workers, and others who are regularly exposed to such conditions. People suffering from long-standing hypertension or diabetes may also have a higher risk. For this reason, he stressed the importance of maintaining a pollution-free environment and engaging in regular physical exercise.
However, the cost of DBS treatment remains a major challenge. The procedure can cost approximately ₹20 lakh, forcing many patients to depend on charitable organizations or financial assistance programs to access this advanced therapy.
