Parkinson’s disease is an age-related, chronic disease of the human brain. The disease is named for the British physician James Parkinson, who in 1817 published an Essay on Shaking Palsy.
In this disease, damage to the dopaminergic cells of the substantia nigra, globus pallidus, striatum and other structures of the central nervous system occurs. All of them are responsible for the adequacy of movements of the striated, skeletal muscles.
As a result, the ability to make clear, meaningful movements is impaired. Tremors (tremors) and other characteristic symptoms occur.
Manifestations and diagnostics
The main symptoms of Parkinson’s disease are associated with movement disorders:
- tremors (tremors) of the limbs;
- changes in muscle tone, they become tense, rigid;
- deterioration in mobility;
- postural instability – dizziness when changing body position;
- speech disorders due to poor regulation of the muscles of the larynx and tongue;
- depression, etc.
The main reasons for this pathology are genetic predisposition and TBI. For example, the great boxer Mohammed Ali has Parkinson’s disease.
For the diagnosis of PD, neurological examination, MRI of the brain, myography, electroencephalography, evoked potentials, and biochemical analyzes are used.
Treatment
The purpose of drug treatment is the correction, elimination of movement disorders. The drugs used are those that can eliminate the deficiency of the neurotransmitter dopamine.
- Some increase its secretion by the remaining neurons of the substantia nigra.
- The second group reduces the breakdown of available dopamine.
- The third is drugs that are substitutes for dopamine.
As a rule, combinations of funds from all three groups are prescribed.
The main role is given to levodopa (an analogue of natural dopamine) and its combination with other drugs.
Such as DOPA inhibitors, COMT, MAO inhibitors and dopamine receptor agonists.
The first problem is that these drugs have many severe side effects. Among them – aggressive skin cancer melanoma. The second is that the brain gets used to drugs. The dose sufficient to relieve symptoms must be increased continuously.
Therefore, doctors continue to search for alternative methods. Thus, operations are proposed and carried out to introduce microelectrodes into the brain that stimulate structures that “fall asleep” without dopamine. A similar effect can be produced non-invasively, without neurosurgery. Using transcranial magnetic stimulation (TMS).
Transcranial magnetic stimulation in Parkinson’s
Practical testing of TMS began at the beginning of the 21st century. So, in 2004 in France, the positive effect of transcranial magnetic stimulation in PD was investigated. The areas of the projection of the motor cortex served as the point of application, the symptoms were noticeably reduced.
Further, the positive effect of TMS was confirmed by Canadian doctors. Thanks to the effect on the brain of an alternating magnetic field, handwriting and fine motor skills improved in people with parkinsonism.
The Chinese use the technique to improve gait and stability. In Japan, using the TMS method, they try to minimize all the negative manifestations of the disease.
Thus, transcranial magnetic stimulation can have a complex positive effect on movement disorders in Parkinson’s disease. The results are influenced by the characteristics of stimulation, the stage of the disease, and the duration of treatment. Particularly good results are achieved with complex treatment using physical rehabilitation methods.
In the United States, transcranial magnetic stimulation is effectively used in the treatment of psychological disorders characteristic of Parkinson’s disease: depression, psychosis. Due to this, the quality of life of the patients themselves and their loved ones increases. Since patients require less care, they retain the ability to self-care longer.
For the effective use of TMS in patients with Parkinson’s disease, modern diagnostic and therapeutic equipment is not enough. The scientific and practical experience of doctors in brain stimulation, deep knowledge of neurophysiology and neurology are important.
Comments by Professor R.F. Gimranova
“In the Clinic for Reconstructive Neurology, TMS is used for the diagnosis and treatment of Parkinson’s disease in many countries of the world. We began to use transcranial magnetic stimulation for the treatment of such patients in 1993, one of the first in the world. We have accumulated experience of such therapy in the treatment of more than 4 thousand patients. The highest effects are possible only with individually selected stimulation, in combination with other methods of treatment.
We agree with the opinion of Western doctors that for the successful use of TMS for the treatment of PD, it is necessary to train a specialist for at least 5-6 years after graduation. “