In trials, patients with a stable response to levodopa drugs who took Tasmar experienced significant improvements in daily activities such as talking, writing, walking, and dressing. They are sometimes given with levodopa drugs to improve response. The Activa Tremor Control Therapy consists of a wire surgically implanted deep within the brain and connected to a pulse generator, similar to a cardiac pacemaker, implanted near the collarbone. Whenever a tremor begins, patients can activate the device by passing a hand-held magnet over the generator. The system delivers a mild electrical stimulation that blocks the dysfunctional brain signals that cause tremor.
Effects are often dramatic.
Doctors are not sure why the procedure works, but an October 1997 report in the New England Journal of Medicine stated that half of the patients in a pallidotomy study at Toronto Hospital, who before the surgery needed help in eating, dressing, and personal hygiene, were able to resume these activities independently. The study cautioned, however, that some of the surgery's effects diminished after two years and that the long-term effectiveness of the procedure still is unknown. In pallidotomy, a surgeon makes a tiny hole in the skull and uses a tiny electric probe to destroy a small portion of the globus pallidus, which experts believe is overactive in Parkinson's patients. The patient is kept awake, but under sedation, so the surgeon can note responses to stimuli. Though both sides of the brain have a globus pallidus, pallidotomies typically are performed on one side at a time.