A therapeutic approach able to change for the better the quality of life of the patient suffering from Parkinson’s disease, a system – Infinity made by St. Jude Medical – implanted for the first time in Italy thanks to the collaboration between the Parkinson Center Neurological Institute “C. Mondino “Functional Neurosurgery of Pavia and IRCCS Galeazzi Orthopaedic Institute of Milan, which represent more than 15 years an established national reference point for the DBS in Parkinson’s Disease.
The Infinity system is the latest innovation in the field of deep brain stimulation or deep brain stimulation (DBS), a procedure of functional neurosurgery that has more than 20 years, the effectiveness of which, proven worldwide, has recently been improved by the development of directional electrodes that allow a greater accuracy of dispensing of the electric field, satisfying, with a tailored approach, the patient’s therapeutic needs. The procedure is able to be updated and to incorporate improvements without the need to repeat the surgical procedure.
are about 1,500 patients with parkinsonian syndromes followed as outpatients each year at Mondino, residents in Lombardy and neighboring regions, and over 300 hospitalized patients annually in the department dedicated to the advanced stages for high-tech care.
candidates intervention, selected to Mondino, are sent to the department of neurosurgery of the Galeazzi where they are subjected to the surgical procedure. They are 40-45 year new DBS installations performed at this property. In 80% of cases it comes to patients suffering from Parkinson’s disease but they also treated other movement disorders such as dystonia and essential tremor and behavioral disorders such as obsessive-compulsive disorder.
“Parkinson’s is a disease with increasing incidence due to age more and more advanced in the general population,” – says Professor Claudio Packages, director of the Parkinson’s Neurological Institute C. Mondino – “In Italy, every year , they get sick “from scratch” from 8,000 to 12,000 people, including many young people under 50 years. The available dopaminergic drugs allow you to deal effectively and for longer periods of motor symptoms, tremor, muscle stiffness and motor slowing, greatly improving the quality of life of people. In the more severe stages of the disease, when drug therapy is no longer sufficient, it is necessary to resort to more advanced therapies: that is the moment in which it is proposed for DBS. The neuro-stimulator delivers an electric current and through thin electrodes placed in the deep brain nuclei, the subthalamus or globus pallidus, and generates pulses capable of “liberating” the motor cortex, improving the symptoms of the disease, the skills and people’s quality of life. “
the electrodes for conventional DBS have a limited ability to direct electrical stimulation and can be difficult to provide effective incentives for specific areas of the brain avoiding side effects. The new directional electrodes, the Infinity system, lead to better management of symptoms as they can optimize the neuro modulation calibrandola tailor and adapt it to the needs of the patient, increasing the benefits and reducing the side effects. Doctors can program the neurostimulator their patient through a digital iPad Mini, with Bluetooth wireless technology, safe and wireless.
“The role of the neurosurgeon in the interventions of deep brain stimulation is still to reach the target with the maximum possible accuracy “- says Prof. Domenico Servello, director of the Institute of Functional Neurosurgery Galeazzi -” and our center is the only one in Italy and among the few in the world to use the intraoperative CT scan to improve the accuracy of the system. Certainly the new directional electrodes represent an additional tool to optimize stimulation and therefore the effectiveness of the procedure by reducing the risk of unwanted side effects. In particular their use may even prove essential in certain diseases when being used as a target of stimulation brain structures not directly recognizable on MRI so more difficult to reach with precision. “
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