NEW DELHI: In recent decades, the demographics of people with Parkinson’s disease (PD), which was once thought to primarily affect the elderly, have changed. Doctors suggest that in the last 25 years, the prevalence of the disease has doubled.
In 2019, about 8.5 million people worldwide were reported to be affected with Parkinson’s with 3.29 lakh deaths. India faces a unique challenge – a younger average age of Parkinson’s onset, often striking people a decade earlier, around 51-years of age.
This has devastating consequences, affecting individuals during their peak earning years. Studies like the one conducted in Gujarat has revealed a prevalence of 42.3 per one lakh, highlighting a significant disease burden. Experts are of the view that the treatment landscape for Parkinson’s disease in India is undergoing a positive transformation with a mix of several treatment methodologies.
Levodopa is still the principal medicine used for treatment due to its consistent efficacy since it was first introduced in the 1960s. However, Dr Rajnish Kumar, director, neurology, Paras Health, Gurugram, said levodopa may cause patients to have dyskinesia, or excessive involuntary movements.
Using common drugs to address these symptoms can be difficult. For such medication-resistant cases with severe tremors or dyskinesia, deep brain stimulation (DBS) surgery has come as a beacon of hope. “We are now looking for advanced treatments like deep brain stimulation (DBS) surgery in these situations. DBS successfully lowers levodopainduced dyskinesia and relieves Parkinson’s disease symptoms,” Kumar added.
What is Deep Brain Stimulation?
Deep brain stimulation (DBS) is a medical procedure which involves applying a small amount of electrical current to a particular area of your brain. This process makes current reach the brain through wires attached to a small device implanted beneath the skin, close to the collarbone.
PD patients require brain computed tomography (CT) and magnetic resonance imaging (MRI) scans to determine the ideal location for DBS lines. “Patients with PD who maintain a clear response to levodopa are candidates for DBS when motor complications cause disability or reduced quality of life, despite optimal oral levodopa or adjunctive therapies,” said Dr Jyoti Bala Sharma, director – neurology, Fortis Hospital, Noida. Despite many advances, there is an affordability hurdle in undergoing DBS.
“When it comes to Parkinson’s, early diagnosis and timely beginning of suitable treatment are essential. While DBS can significantly improve a patient’s quality of life, its high cost remains a major barrier for many,” said Dr VP Singh, chairman, neurosurgery and neurosciences, Medanta, Gurugram However, he added that exploring gene therapy and stem cell therapies in patients with Parkinson’s hold promise for the future.
Stem cells have the potential for selfrenewal through unlimited replication, as well as the capacity to change into any cell type within the body. The ability to direct the fate of these cells to become a dopaminergic neuron potentially therefore offers a treatment option for Parkinson’s disease,” Dr Sharma said. “Gene therapy involves knocking out the gene causing Parkinsonism. This is possible in certain types of Parkinson’s disease that are associated with single gene defects,” she added.