Prescription drugs are the most common, and usually the first, type of treatment given for Parkinson’s disease. DBS can be used on one or both sides of the brain. Whichever side of the brain it’s used on, it will mainly affect the opposite side of the body. If you get DBS surgery, you may have to return to the medical center frequently for a few months to have the stimulation carefully adjusted. After the first few months, you will need it checked occasionally. In older DBS models, the pulse generator needed to be replaced every three to five years, but newer models have rechargeable batteries, which need to be replaced much less frequently. Recharging can be done at home using a portable charger that’s placed over the implant.
Who’s a Candidate for DBS?
Although DBS is the most common surgery for Parkinson’s disease, it’s not appropriate for everyone. The procedure seems to help people for whom levodopa has become less effective over time, or for people who have developed disabling side effects from levodopa (such as dyskinesia — involuntary twisting or writhing movements). One area of research is exploring whether it’s helpful to employ DBS earlier in the course of the disease — while levodopa is still working. DBS isn’t recommended for people with memory problems, hallucinations, severe depression, poor health, or a consistently poor response to levodopa. DBS hasn’t been shown to benefit people with other parkinsonisms (disorders that cause Parkinson’s-like symptoms). As with any surgery, DBS surgery carries a risk of infection. Because DBS is a brain surgery, there’s also a small risk of brain hemorrhage or stroke. Pallidotomy and thalamotomy have become the focus of research again because ultrasound versions of these procedures can be performed noninvasively, without the need for surgery. Constipation can be a problem for people with Parkinson’s, so a fiber-rich diet with plenty of fluids may help. Dietary fiber comes from plant foods — fruits, vegetables, whole grains, and legumes — all of which are components of the Mediterranean diet. Protein in the diet can limit the absorption of the drug levodopa, so this medication is best taken without a lot of protein. Research is ongoing about the possible benefits of antioxidants, caffeine, and supplements in people with Parkinson’s. But there’s no conclusive evidence that any specific dietary factors are helpful in preventing or treating the condition. Always tell your doctor about any supplements or herbs that you’re taking, as they may interact with medications.
Tai Chi
Qi Gong
Speech Therapy
A speech therapist may be able to help you overcome problems related to speaking and swallowing.
Occupational Therapy
An occupational therapist can help you develop techniques to aid with daily activities like dressing, eating, bathing, and writing.
Dance
The Dance for PD program, which offers specialized dance classes to people with Parkinson’s disease online and, in some communities, in person, gives people with Parkinson’s an opportunity to express themselves creatively while also helping with balance, flexibility, strength, and rhythm. The program is administered by the Mark Morris Dance Group.
Choral Singing
Feldenkrais Method
Alexander Technique
Yoga
Yoga may help improve motor symptoms in people with Parkinson’s similar to other forms of exercise. Yoga classes are also widely available, so if you enjoy yoga, it’s a great way to stay active.
Boxing
Instructors at the nonprofit organization Rock Steady Boxing teach boxing exercises to help improve agility, muscular endurance, and hand-eye coordination among people with Parkinson’s. Classes are taught in gyms around the world; locations can be found on the organization’s website. Some alternative therapies for Parkinson’s include the following.
Acupuncture
Studies of acupuncture for various symptoms of Parkinson’s have had mixed results. In general, though, they have found that people who receive acupuncture show more improvement than those who receive no additional therapy beyond their usual care.
Cannabis
Many people with Parkinson’s disease report that they have tried cannabis in some form to treat Parkinson’s symptoms. Some say it helped reduce stiffness and tremor, while others note benefits in memory, mood, and fatigue. Many also report negative side effects, such as confusion, anxiety, and dizziness. So far, studies of cannabis have been small and have had mixed results.
Massage
Meditation
While there’s little research on meditation and Parkinson’s disease specifically, many people find that a regular meditation practice can reduce stress and improve their sense of well-being.
Music or Art Therapy
Pet Therapy
For many people, this leads to feelings of loneliness, which is increasingly being recognized as both a physical and mental health hazard. Most people living with a chronic disease agree that no one understands them quite like another person living with the same condition. Feeling seen and understood can make a big difference in how you feel about yourself and your life. One way to connect with others facing the same challenges is to seek out a peer support group through a national organization like the Parkinson’s Foundation, the Michael J. Fox Foundation’s Parkinson’s Buddy Network, or through the hospital or clinic where you receive medical care. Another is to look for a Parkinson’s self-management program in your area. One example is PD Self, which is designed for people who have been diagnosed with Parkinson’s within the previous three years. But your neurologist may know of others. The care partners of individuals with Parkinson’s can also benefit from participating in educational programs and support groups aimed at them. The Parkinson’s Foundation Care Partner Program is one place to start, and the American Parkinson Disease Association offers support groups for care partners. Additional reporting by Ingrid Strauch.