The Movers and Shakers are back in the Notting Hill pub, and this week they're joined by an illustrious guest. Professor Ludvic Zrinzo is a world renowned specialist in Deep Brain Stimulation (DBS) and, in her own words, the "only man to have been been inside my [Gillian's] brain". DBS is an exciting but often misunderstood treatment in the world of Parkinson's care, and the gang are going to put Prof Zrinzo under the microscope. Who is right for DBS? Are there symptoms it won't help? And why are waiting lists so bloody long?
By Podot
Each week Rory Cellan-Jones guides us between the laughs and moans in the pub. To read Rory's summary of this week's episode click here.
This week's main guest:
Professor Ludvic Zrinzo
Prof Zrinzo is head of the UCL functional neurosurgery unit. He specialises in the surgical management of chronic neurological disease including Parkinson's disease, dystonia, tremor, headache (cluster headache and other autonomic cephalalgias) as well as the surgical management of treatment refractory mental disorders, including Tourette's syndrome, obsessive compulsive disorder (OCD) and major depression. In addition to stereotactic ablation and deep brain stimulation (DBS) he also specialises in disorders of the cranial nerves, including microvascular decompression (MVD) procedures for trigeminal neuralgia and hemifacial spasm.
Prof Zrinzo completed undergraduate medical studies in Malta, before moving to London to train in neurosurgery (Atkinson Morley Hospital, Royal London Hospital, Great Ormond Street Hospital, The National Hospital for Neurology and Neurosurgery and Old church Hospital). He was awarded an MSc in clinical neuroscience with distinction from the UCL Institute of Neurology, London and completed two fellowships in stereotactic and functional neurosurgery, at Queen Square and at UCLA, Los Angeles, USA.
Prof Zrinzo's research interests have been directed towards continued improvement in the surgical care of Parkinson's with particular emphasis on improving safety, accuracy and efficacy of surgery. He is the author of numerous peer-reviewed publications, abstracts and several book chapters and his work has received several international awards.
For more information visit UCLH.
New DBS trial offers hope for Parkinson's, Rory Cellan-Jones
When I first started telling people about my Parkinson’s diagnosis three years ago, a few who knew a bit about the condition had a question for me - are you going to try Deep Brain Stimulation?
Image by Hellerhoff, via Wikipedia (CC BY-SA 3.0)
DBS is a pretty serious surgical procedure involving placing a device in the brain which sends electrical impulses to target specific areas with the aim of controlling Parkinson’s symptoms such as tremors. It’s used only when medication has failed to do that job.
So my answer was always a polite "no", while thinking privately "are you bonkers? I’m not having my head drilled open in some Frankenstein experiment when my symptoms aren’t that bad and I’m only just starting on medication."
No doubt an over-reaction on my part, though the statistics appear to show that DBS, which first got regulatory approval in the US 25 years ago, is still a pretty fringe treatment, available to under 5% of people with Parkinson’s worldwide.
But this week comes news of a trial which could make Deep Brain Stimulation a simpler and less expensive procedure, meaning it could be offered to far more people. The trial is happening in Bristol and involves finding out whether the world’s smallest DBS device is both safe and effective.
Existing devices involve a battery being implanted in the patient’s chest with wires then running up under the skin to the brain. But the Picostim DBS system, is about a third the size of conventional devices, meaning the battery can be implanted directly into the skull, making the whole procedure simpler and less of an ordeal.
The plan is for up to 25 patients to test the device but one, Tony, had his implanted back in November 2020 and seems happy with the results, explaining that he woke after surgery and was surprised that he had no pain. "I was operated on a Wednesday and went home on Thursday afternoon, I felt tired but, I still had no pain," he says. "The impact has been amazing, the dystonia which is a side effect from the medication has gone. I can now walk two miles or more, whereas before DBS, I could get about 200 yards then I would have to rest. I am back playing golf, not as well as I used to, but that’s probably down to old age catching up; but at least I’m back playing."
This episode was recorded before Paul began his Deep Brain Stimulation journey. If you would like to listen to Paul's diary please click here.
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