MICHELE TAGLIATI, MD: It is a neurodegenerative disease that is caused by the premature death of a small area of the brain that produce a neurochemical that is called dopamine. And the brain use dopamine to send signals to the muscles and make our movement coordinated and appropriate for our function during the day.
DAVID MARKS, MD: So when there's not enough dopamine, what happens? What are the symptoms that make the diagnosis?
MICHELE TAGLIATI, MD: There are three cardinal symptoms of Parkinson disease. One is tremor, that is usually present at rest and not during any particular movement. The second one is an unusual slowness of movement and a lack of coordination and dexterity in your fine movements. And the third one is a stiffness of your muscle that we call rigidity. There is a fourth symptom that usually occur late in the disease that is an abnormality of balance that unfortunately cause frequent falls in the patients.
DAVID MARKS, MD: Now Dr. Alterman, there are a lot of new treatments available now. Tell us about some of these new brain surgery treatments.
RON ALTERMAN, MD: Well, first of all, medical therapy continues to be the front-line therapy for Parkinson's disease and l-dopa continues to be the gold standard of those medical therapies.
We now know, however, that the medical therapies over time will lose their effectiveness and when medicine is no longer adequately controlling the patient's symptoms, then surgery becomes appropriate. And of the surgeries, the best -- or the most effective -- surgery thus far has been deep brain stimulation. And specifically deep brain stimulation at the subthalamic nucleus. And this surgery was approved by the FDA for use in the United States.
