Deep Brain Stimulation Improves Incontinence and Parkinson’s

Recent research estimates approximately 27-39% of people with Parkinson’s experience urinary difficulties. New research shows deep brain stimulation may be effective for incontinence.

Deep brain stimulation is a surgical procedure for Parkinson's Disease. Its purpose is to help ease motor symptoms and decrease medication needs. Whilst showing successful in treating motor system disorders, it’s effect on urinary function has not been hugely investigated. However, recent research from a study at Beijing Tiantan Hospital has found it to be effective in improving urinary function. Beijing based urologists analysed responses of 416 patients from the UK diagnosed with Parkinson’s Disease. 220 of these received DBS surgery. In comparison to those who did not receive DBS surgery, patients who received the surgery experienced significant improvements in urinary incontinence and urgency. It was also reported that the surgery decreased the frequency in which people visited the toilet. The study found that urinary incontinence frequency improved after GPI DBS and STN DBS at 12 months. It did not, however, treat symptoms of nocturia, residual urine and dysuria.

What Occurs During Deep Brain Stimulation?

The surgery involves implanting very fine wires with electrodes at their tips, into the brain in specific areas which control movement. These are connected to extensions that are tunnelled under the skin behind the ear and down the neck. A pulse generator is placed under the skin around the chest or stomach. A few weeks after surgery, a specialist in movement disorder will program the neurostimulator to help treat your specific symptoms. The DBS settings will be gradually tweaked by a Doctor depending on your progress.

Who is the Surgery Ideal For?

Deep brain stimulation is approved for people who have had Parkinson’s Disease for at least four years. It is ideal for people who get a benefit from medication but have motor complications.

Incontinence and Parkinson’s Understanding the Link

Urge incontinence and Nocturia are the most common types of bladder problems in Parkinson’s Disease. Having to get out of bed frequently is a common complaint from people with Parkinson’s and incontinence. According to a recent study, urgency is actually the most bothersome symptom. Incontinence can occur due to a disruption in the messages from the brain to the bladder. In individuals with Parkinson’s Disease, the brain lacks complete control over the sphincter. Parkinson’s Disease attacks dopamine-producing cells, which deal with signals controlling muscle movement. In some people with PD, the bladder can have unwanted contractions which are impossible to stop.

Those with Parkinson’s are more likely to have problems with their bladder or bowel than people without the condition

The Pros and Cons of Deep Brain Stimulation

There are good and bad aspects of deep brain stimulation.

Pros

• Deep brain stimulation is a non-destructive type of surgery
• Proven to be more effective than ablative surgical procedures
• The stimulator is adjusted to the needs of the patient
• It is reversable, which leaves the option open of alternative surgery
• Fewer long-term complications than traditional surgery

Cons

• It doesn’t work as well for imbalance, freezing of gait (sudden inability to move when walking) or non-motor symptoms
• It may worsen thinking or memory problems, so it is not recommended for people with Dementia

What are the Symptoms of Parkinson’s Disease?

Parkinson’s Disease can affect every individual differently. However, the most common symptoms are the following:

• Tremors
• Slowness of movement
• Fatigue
• Muscle Cramps
• Difficulty with speech and communication
• Rigidity

Light Incontinence

Moderate Incontinence

Heavy Incontinence