Parkinson’s disease is a slowly progressing degenerative brain disorder that leads to tremors and difficulties with walking, balance, and coordination. It is the most common form of parkinsonism, a group of motor system disorders. There is no cure for this disease but there are highly effective treatments that can significantly ease the symptoms of Parkinson’s disease and allow patients to live a productive and fulfilling life.
At Brigham and Women’s Hospital, our multidisciplinary Movement Disorders Program provides comprehensive evaluation and treatment for patients with a broad range of movement disorders, including Parkinson’s disease, tremor, and dystonia. Our team of physicians, nurses, and researchers is dedicated to advancing the understanding and treatment of Parkinson’s disease and related disorders. Research projects include:
Parkinson’s disease is one of the many diseases and conditions that form the focus of our Neurosciences Center. Our multidisciplinary team of neurologists, neurosurgeons, psychiatrists, neuropsychologists and neuroradiologists offers the most innovative and advanced treatments and therapies for Parkinson’s and all diseases of the nervous system. Our dedication to discoveries and research in these areas has made us the choice for patients from the region and around the world.
Roughly 60,000 Americans are newly diagnosed with Parkinson’s disease each year, and more than 1 million Americans are affected at any one time. The specific cause of Parkinson’s disease is unknown but experts believe the symptoms are related to a chemical imbalance in the brain caused by the loss of dopamine-producing brain cells.
Dopamine is a chemical that helps the nerve cells in the brain communicate with each other. When dopamine is missing from certain areas of the brain, the messages that tell the body how to move are lost or distorted - resulting in movement disorders associated with Parkinson’s disease.
It is important to find specialists who are expert in the complexities of Parkinson’s care and who have access to the latest discoveries in the diagnosis and treatment of this disease.
Parkinson’s disease risk factors are:
Researchers postulate that in most individuals, the cause of Parkinson’s disease is the combination of genetics and environmental exposure and certain toxins including insecticides and herbicides.
Every individual experiences symptoms differently, but the most common symptoms are:
There are other secondary movement and non-movement symptoms of Parkinson’s disease.
Additional movement symptoms:
Additional non-movement symptoms:
The symptoms of Parkinson’s disease can resemble symptoms for other conditions or medical issues. It is important for symptoms, such as these, to be fully evaluated by a specialist who can provide a proper diagnosis.
Making an accurate diagnosis in the early stages of Parkinson’s disease can be more difficult, as the beginning signs and symptoms can be considered indications for other medical conditions or even the effects of normal aging. At Brigham and Women’s Hospital, our Parkinson’s specialists – neurologists and neuro-radiologists – provide expert evaluation and diagnosis utilizing the latest in advanced imaging technologies.
In addition to a thorough medical history and detailed neurological examination, diagnostic testing for Parkinson’s can include:
At Brigham and Women’s Hospital Parkinson’s specialists develop individualized Parkinson's disease treatment plans for patients based on:
Because there currently is no cure for Parkinson’s, current treatments focus on easing symptoms and making day-to-day life more manageable for patients.
Parkinson’s disease treatment options may include medication or surgery along with supportive services such as psychiatry services, therapy services, and nutrition and wellness plans.
Once the diagnosis of Parkinson’s disease has been established, the next step is to determine if medical treatment is appropriate and the best option for the patient. Our Parkinson’s specialists will look at the following factors when considering medical treatment:
The common goal for all medications used to treat Parkinson’s disease is to compensate for the shortage of the brain chemical dopamine, which causes the symptoms of the disease.
Options for medication include:
Every patient responds differently to medical management of Parkinson’s disease, therefore medications and their dosages often are adjusted until the right balance is found to alleviate symptoms.
Surgical treatment for Parkinson’s disease is aimed at reducing the tremor or rigidity that accompanies the disease as well as the disabling side effects that can occur from prolonged medical treatment which actually make the symptoms worse.
The most common surgical procedure used for Parkinson’s disease treatment at Brigham and Women’s Hospital is deep brain stimulation (DBS), a type of brain surgery in which electrodes deliver electrical impulses to specific targets in the brain for the treatment of movement and affective disorders. The primary goal of DBS is to improve the patient’s quality of life by managing symptoms, not to cure the disease or disorder.
Brigham and Women’s Hospital, through the Deep Brain Stimulation Program, is one of only few centers in New England that provides this therapy and the only center in New England to offer both awake DBS and asleep DBS.
This procedure is typically offered to patients who have advanced Parkinson’s disease, whose symptoms cannot be well-controlled with medications, or whose medications have produced severe side effects.
Other surgical procedures that may be appropriate for Parkinson’s disease treatment include classic thalamotomies and pallidotomies, lesion surgery (burning of tissue in the area of the brain causing tremor), stereotactic radiosurgery, and experimental neural grafting. Also, research is ongoing to perform thalamotomies and pallidotomies without incision using high energy focused ultrasound.
If a surgery is indicated for treatment, the surgeon will work with the patient and their family to determine the best option and develop a treatment plan.
Living with Parkinson’s disease does have an impact on mental health and often can lead to depression. At Brigham and Women’s Hospital, Parkinson’s disease patients have access to the services they need to cope with the challenges they face on a day-today basis.
Specialists within the Department of Psychiatry at Brigham and Women’s Hospital provide a broad range of programs, including specialized services that address the unique needs of patients living with chronic conditions, such as Parkinson’s disease.
An integral part of Parkinson’s disease treatment is ensuring that each patient receives all the support services they need to help manage the impact the disease has on their overall health and well-being.
Part of the multidisciplinary care provided at Brigham and Women’s Hospital, many patients with Parkinson’s disease also benefit from:
Brigham and Women’s Hospital provides a multidisciplinary approach to patient care, collaborating with colleagues in other medical specialties. If your neurologist or neurosurgeon discovers an underlying illness or concern, you will be referred to an appropriate Brigham and Women’s Hospital physician or allied health professional for an expert evaluation.
Parkinson’s disease specialists:
The Deep Brain Stimulation (DBS) Program is composed of nationally known physicians from a variety of disciplines, all specializing in the treatment of movement and psychiatric disorders. Our integrated approach helps to ensure seamless patient care. The DBS team includes movement disorder neurologists, neurosurgeons, psychiatrists, neuropsychologists, and administrative staff.
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