Managing your Parkinson’s
Taking control of your Parkinson’s disease (PD) begins with education. Understand the treatment options available to you and make a plan to utilize resources, specialists, and support throughout your journey.
Step it up with exercise
You already know that exercise should be part of your weekly routine. It keeps our minds and our bodies in alignment. This is even more crucial as you face your Parkinson's diagnosis. Studies show exercise slows the progression of symptoms in people with PD. In a 10,000-patient clinical trial, at least 2 1/2 hours of physical activity each week—including strength, flexibility, and aerobic exercise—has been shown to prolong quality of life.1
“I feel confident that as soon as I get these quads back, I’m going to be back, and that’s pretty exciting.”
—Ken B., Boston Scientific DBS Patient, Fountain Hills, AZ
Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary.
Finding relief with medication3,4,5
While every person's treatment plan will differ, almost all will start with medication, which tends to be the most effective in the early stages. The optimal medication plan varies from person to person, and your doctor can help you find the right medication—or combination—to give you the most relief with the fewest side effects. Over time, as medications become less effective, doses may be increased, and new medications can be added.2
Levodopa (l-dopa)
How It Works
Chemical “precursor” that the brain will convert to dopamine. Used to replace the dopamine that is not being produced in the brains of people with PD
Common Brand Names
Larodopa®
Carbidopa
How It Works
Prevents the breakdown of L-DOPA before it reaches the brain. Almost always given in conjunction with L-DOPA
Common Brand Names
Parcopa®
Sinimet®
Rytary™
Duopa™
(carbidopa/levodopa)
Dopamine agonists
How It Works
Can be used in place of, or in combination with, levodopa
Common Brand Names
Neupro®
Requip®
Dostinex®
Permax™
Mirapex®
Parlodel®
Apokyn®
Catechol-O-methyltransferase (COMT) inhibitors
How It Works
Increases the concentration of dopamine in the brain, giving more opportunity for the drug to work
Common Brand Names
Comtan®
Stalevo®
Tasmar®
Anticholinergics
How It Works
Reduces tremor or rigidity1
Common Brand Names
Akineton®
Artane®
Cogentin®
ON/OFF fluctuations with Levodopa treatment
Early PD
Initially, many people achieve good motor control with L-DOPA therapy (“ON time”). As the dose wears off, the symptoms of Parkinson’s return (“OFF time”).
As Parkinson’s advances, medication may lose its ability to control your motor symptoms.
Moderate PD
As the disease advances, additional doses may be needed at more frequent intervals to achieve control.
Advanced PD
Very high doses of L-DOPA can cause unintended side effects, such as dyskinesia—rapid, uncontrolled movements. ON/OFF fluctuations are often a catalyst for a switch to other medication.3,4,5
Surgical treatment options4
As PD progresses, you may notice a decrease in efficacy of your medication or an increase in side effects. As changes arise, talk to your care team immediately about alternatives that may reduce symptoms and reclaim your quality of life.
Ablative surgery
Pallidotomy and thalamotomy are non-reversible surgeries that use targeted application of heat to destroy neural tissue driving Parkinson’s symptoms. This procedure targets and “ablates” the area of the brain affected by PD, thereby decreasing symptoms.
Deep Brain Stimulation (DBS)
DBS is designed to help control motor symptoms while allowing for a reduction in medication. DBS involves inserting a stimulator that sends tiny pulses of electricity to the brain to interrupt the overactive cells that cause PD. For DBS to be effective, the device must be implanted when motor symptoms are still responsive and before PD drugs lose their effect, which is why it’s crucial to speak to your doctor when you begin to notice this change.
Support in numbers
While talking to specialists, friends, and even therapists is important throughout your journey, you may find it helpful to speak to others with PD on the same path as you. Joining support groups is a valuable way to discover new information, find resources, and share a common experience with others.
In-person support
Your neurologist, local hospitals, and community outreach programs can help point you in the right direction for in-person support groups. You may even start your own PD support group in your area by telling your doctor of your desire or creating a group or posting online.
Online support
Get support online without leaving the comfort of your couch. Here are a few popular forums:6
We're here to answer your DBS questions
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References: 1. Science Daily. Why exercise slows progression of Parkinson's disease. Accessed July 1, 2021. https://www.sciencedaily.com/releases/2017/12/171223134846.htm 2. Parkinson’s Foundation. Stages of Parkinson’s. Accessed June 30, 2021. https://www.parkinson.org/Understanding-Parkinsons/What-is-Parkinsons/Stages-of-Parkinsons 3. Brain & Life. Parkinson’s disease. Accessed June 30, 2021. https://www.brainandlife.org/disorders-a-z/parkinsons-disease/ 4. Mayo Clinic. Parkinson’s disease. Accessed June 30, 2021. https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055 5. Okun MS, Foote KD. Parkinson’s disease DBS: what, when, who and why? The time has come to tailor DBS targets. Expert Rev Neurother. 2010;10(12):1847-1857. doi: 10.1586/ern.10.156 6. Michael J. Fox Foundation. Support Groups. Accessed July 1, 2021. https://www.michaeljfox.org/news/support-groups
Indications for Use: The Boston Scientific Deep Brain Stimulation Systems are indicated for use in:
- Bilateral stimulation of the subthalamic nucleus (STN) as an adjunctive therapy in reducing some of the symptoms of moderate to advanced levodopa responsive Parkinson's disease (PD) that are not adequately controlled with medication.
- Bilateral stimulation of the internal globus pallidus (GPi) as an adjunctive therapy in reducing some of the symptoms of advanced levodopa responsive Parkinson's disease (PD) that are not adequately controlled with medication.
Contraindications, warnings, precautions, side effects: The Deep Brain Stimulation Systems or any of its components, is contraindicated for: Diathermy as either a treatment for a medical condition or as part of a surgical procedure, Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS) as the safety of these therapies in patients implanted with the Vercise™ DBS System has not been established, patients who are unable to operate the system, patients who are poor surgical candidates or who experience unsuccessful test stimulation. Patients implanted with Boston Scientific Deep Brain Stimulation Systems without ImageReady™ MRI Technology should not be exposed to Magnetic Resonance Imaging (MRI). Patients implanted with Vercise Gevia™ or Vercise Genus™ or Vercise DBS Lead-only system (before Stimulator is implanted) with ImageReady MRI Technology are Full Body MR Conditional only when exposed to the MRI environment under the specific conditions defined in ImageReady MRI Guidelines for Boston Scientific Deep Brain Stimulation Systems. Assess patients for the risks of depression and suicide. This assessment should consider both the risk of depression and suicide as well as the potential clinical benefits of DBS therapy. Monitor patients for new or worsening symptoms of depression, suicidal thoughts or behaviors, or changes in mood or impulse control and manage appropriately. Refer to the Instructions for Use provided with the Vercise DBS System or BostonScientific.com for potential adverse effects, warnings, and precautions prior to using this product.
Warnings: Unauthorized modification to the medical devices is prohibited. You should not be exposed to high stimulation levels. High level of stimulation may damage brain tissue. Patients implanted with the Vercise DBS System may be at risk for intracranial hemorrhages (bleeding in the brain) during DBS lead placement. Strong electromagnetic fields, such as power generators, security screeners or theft detection systems, can potentially turn the stimulator off, or cause unpredictable changes in stimulation. The system should not be charged while sleeping. If you notice new onset or worsening depression, changes in mood or behavior or impulse control, or have thoughts of suicide contact your physician or emergency services immediately. Chemical burns may result if the Vercise Stimulator housing is ruptured or pierced. The Deep Brain Stimulation System may interfere with the operation of implanted stimulation devices, such as cardiac pacemakers, implanted cardioverter defibrillators, or medication delivery pumps. Patients should operate motorized vehicles or potentially dangerous machinery with caution. It is unknown if the device may hurt an unborn baby. Your doctor may be able to provide additional information on the Boston Scientific Vercise DBS System. For complete indications for use, contraindications, warnings, precautions, and side effects, call 833-DBS-INFO or 833-327-4636.
CAUTION: U.S. Federal law restricts this device to sale by or on the order of a physician.
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