New treatment to help people with Parkinson's commences in Ireland

Maeve Quigley, 15th March 2022, ((opens in a new window)EVOKE)

A treatment that helps Parkinson’s sufferers by stimulating the brain has been used in Ireland for the first time. The treatment is part of the new National Deep Brain Stimulation Service based at the (opens in a new window)Mater Hospital in partnership with Beaumont Hospital, where all related surgery will be performed.

This new service will treat patients with movement disorders such as Parkinson’s Disease, essential tremor and dystonia.

The treatment controls symptoms in patients who have not responded well or have had short lived responses to traditional treatment with medication. Suitable patients are selected from around the country by a team of six specialist staff at the Mater devoted to deep brain stimulation (DBS).

Initially surgeons implant brain electrodes into the patient at Beaumont Hospital, then the battery attached to these electrodes is activated and programmed a few weeks later in the Dublin Neurological Institute (DNI) at the Mater Hospital.

The level of current delivered in deep brain stimulation is controlled by a pace-maker-like device placed under the skin in the upper chest of the patient, and connected to the electrodes deep within the patient’s brain.

The treatment is established elsewhere in the world for movement disorders, especially Parkinson’s disease, but this is the first time that it is available in Ireland. Daniel McGinty, a Parkinson’s sufferer, was the first patient in Ireland to undergo the treatment.

Ms Catherine Moran, a neurosurgeon at the Mater Hospital and Beaumont Hospital, implanted two electrodes into his brain late last year. Prior to the surgery Daniel had to take his medication every two hours to achieve brief periods where freezing and slowness caused by his Parkinson’s disease were controlled.

‘Preparing for the first surgeries was a significant undertaking by numerous different disciplines within Beaumont Hospital, including radiology, medical physics, theatre staff and our management team,’ says Ms Moran. ‘We now have a surgical programme that incorporates the most advanced technology available in the world.

‘Daniel and his family worked with all the team in the months planning his surgery and after surgery during the programming stage. Their commitment and patience to the process is what allowed us to get the best outcome for him.’

Daniel, who is 49 and from Letterkenny in Donegal, then attended the DNI at the Mater Hospital in December to have the battery attached to his electrodes turned on. Prof Richard Walsh, consultant neurologist at the DNI and clinical lead of the new service, says DBS works in the same way as dopamine in the body.

‘The region of the brain targeted – the subthalamic nucleus and connected circuits – are overactive in people with Parkinson’s disease as a consequence of the loss of a neurotransmitter called dopamine, and give rise to the typical movement difficulties we see in these patients,’ he says.

‘Deep brain stimulation uses a small current to impose a more useful pattern of electrical activity on the involved circuits, which can mimic the effect of Parkinson’s medication, but does so in a much more consistent way on a 24 hour basis, which can be life-changing.’ Daniel has already seen a huge improvement in the control of his tremors and is delighted to have been the first public patient to avail of the new treatment.

‘Getting a diagnosis of Parkinson’s disease in my 30’s was a shock, but for the first few years I was able to manage my condition through medication,’ the Donegal man explains. ‘But my quality of life deteriorated massively over the last two years to the point where I was unable to drive, to go out and enjoy things that everyone else takes for granted.'

‘Even though I only underwent the procedures in December, Deep Brain Stimulation has given me back that quality of life I have been missing.’

Under the new national programme, 24 patients are expected to get treatment from the new service in 2022, eight of whom have already been treated so far. Prof Tim Lynch, consultant neurologist and clinical director of the Dublin Neurological Institute has campaigned for over 20 years to bring this well-established treatment to Ireland.

He is now delighted that Irish patients will now be able to access this treatment in their own country. ‘Up until now we have been referring 12-15 patients per year to the NHS in the UK for deep brain stimulation,’ he says.

‘This has required patients, with significant disability, to make multiple arduous journeys for preoperative assessments surgery, post-operative programming of the battery and subsequent follow-up over the following years.

‘All of these steps can now be provided in Dublin in a collaborative programme developed between the Mater Hospital and Beaumont Hospital with HSE support so the patient gets treated closer to home.’