This is how a brain pacemaker helps patients

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Neurologist PD Dr. Thomas Kogelperger and Professor Günter Höglinger, Director of Neurology at the Grosshadern Clinic with Parkinson's patient Marianne Wenzel and her husband Karl-Heinz.
Two weeks after the brain pacemaker was inserted, Parkinson's patient Marianne Wenzel can stand again, and her husband Karl-Heinz gives her extra support. LMU chief neurologists Prof. Günter Höglinger (right) and Dr. Thomas Kogelsperger (left) are pleased that the patient now feels great again and that the brain pacemaker is curbing her Parkinson's symptoms. © Martin Hangen

Parkinson's is the second most common neurodegenerative disease of the nervous system after Alzheimer's. It develops slowly and is often detected late. However, there have now been huge advances in diagnosis and therapy.

It was only two weeks since the operation when Marianne Wenzel met our editorial team in Großhadern for an interview. She smiles. She can walk again and controls the twitching and spasms of her right leg. The florist from Schwabmünchen is one of 50 patients who have a so-called brain pacemaker implanted at the LMU clinic each year. “The deep brain stimulation be able to The quality of life for many patients has improved significantly for two decades or moren,” says Professor Günter Höglinger, director of the neurological clinic at LMU Hospital. A brain pacemaker is an option for many of the approximately 400,000 Parkinson's patients in Germany, especially when medication cannot consistently improve symptoms. But neurologists regret that only a small portion of those affected choose deep brain stimulation. Because at some point, medications are no longer sufficient to deal with the symptoms. The statutory health insurance companies also cover the costs of a brain pacemaker.

Marianne Wenzel is glad that she had the courage to have a pacemaker inserted in her brain: “I am already seeing a lot of progress.” The 53-year-old woman was a florist by profession. She especially loved making beautiful bouquets. But in 2014 this became more difficult for her. “My hands were shaking and I had no strength left to hold the bouquet,” she says. In addition, her hands increasingly felt as if they had fallen asleep. “There were ups and downs for two years,” she says. Sometimes she felt better, then the symptoms got worse again. She often had difficulty sleeping at night because her legs were so restless. The family doctor diagnosed so-called restless leg syndrome. “I hoped that these problems would go away,” says the woman from Schwabmunch. A neurologist prescribed dopamine tablets. In 2016, he advised her to have a magnetic resonance imaging (MRI) scan to accurately diagnose the cause of her symptoms. During neurological examination, a diagnosis of Parkinson's disease was made.

Neurologist PD Dr. Thomas Kogelperger (left) with Prof. Günter Höglinger, Director of Neurology at the Großhadern Clinic.
Top experts in Parkinson's cases: neurologist PD Dr. Thomas Koglsperger (left) with Prof. Günter Höglinger, director of neurology at the Großhadern Clinic. © Martin Hangen

She was put on medication. Still, the symptoms worsened. She could no longer drive a car or bicycle and walking became difficult. “My husband sometimes had to carry me and it was no longer possible for me to get out of bed. In the morning I was as stiff as a board,” says the 53-year-old. She also began to have difficulty speaking.

Two holes are made in the skull and electrodes are implanted deep into the head

So Marianne Wenzel decided to have a brain pacemaker implanted. For this, LMU neurosurgeon PD Dr. Jan Mehrkens inserted two electrodes permanently into her brain. The implanted electrodes stimulate certain areas. This makes it possible to treat movement disorders. In the first operation on April 10, two small holes were made in Marianne Wenzel's right and left skull and two electrodes were implanted deep into her head. The 53-year-old was awake during the operation, but did not feel any pain or fear thanks to the painkillers and sedatives. Thanks to high-resolution MRI imaging, the neurologists at the LMU clinic can now perform this operation even under general anesthesia.

The brain pacemaker will be adjusted in a few weeks after the operation. “It works. Now my right leg does not wobble and I no longer have bad and painful cramps in my right leg,” Marianne Wenzel says happily. She is confident that she will soon have her motor difficulties completely under control. “Some fine-tuning is still needed here,” explains neurologist Kogelsperger. Using a special smartphone, he can adjust the pulse strength so that the patient is sufficiently active but not overactive. He can also set the brain pacemaker during a virtual consultation – i.e. a telemedicine consultation where patient and doctor see each other on the screen and patients do not have to go to the clinic.

Parkinson's patient Marianne Wenzel and her husband Karl-Heinz at the Michaelimarkt in Schwabmünchen in 2018.
Their love survives every illness: Marianne and Karl-Heinz Wenzel in 2018. © Karl-Heinz Wenzel

Major advances in treatment have led to significant improvements in patients' quality of life

After decades of research on Parkinson's, there have finally been major advances in medicine and technology that help patients. “It is true that Parkinson's disease remains serious and incurable Disease“But in many cases this does not lead to a reduction in life expectancy, and if motivated patients work together with experienced doctors, it is even possible to maintain quality of life,” says chief neurologist Höglinger and adds: “Getting better and better. Read on to the right to find out which complaints could be early warning signs.

Deep brain stimulation: This is how the electrodes help

During deep brain stimulation (DBS). Electrodes deep in the brain Implanted. They stimulate certain areas there, making it possible to treat movement disorders in patients, for example. They are activated by a battery that is placed near the collarbone. Around 50 brain pacemakers are used each year at the LMU clinic. Around 500 DBS patients are being monitored by LMU neurologists. In the weeks following the operation, the timing of stimulation is adjusted to best help the patient control their symptoms. Background: The left side of the brain controls the right side of the body.

This article contains only general information on the relevant health topic and is therefore not intended for self-diagnosis, treatment or medication. It does not in any way replace a visit to a doctor. Our editorial team is not allowed to answer individual questions about medical conditions.

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