当苏珊·维特被诊断出患有 帕金森病 2015年7月，她对这种疾病知之甚少. “当我得到诊断时，我不确定这意味着什么，”维特说. “我只知道我很不舒服，很痛苦."
这个诊断花了四年时间. 2011年，她带着一种奇怪的症状去看医生. 这和她的睡眠行为有关. “我在表演我的梦想，”她说.
在做了一些调查之后, she discovered a potential cause of her symptoms: 快速眼动 (REM) sleep behavior disorder. 她决定把她的发现告诉她的医疗保健大发娱乐提供者. "I met with my GP and handed her a piece of paper describing REM sleep behavior disorder,维特说。. “我告诉她，‘我想我能做到’。”."
快速眼动, 或快速眼动, sleep is a normal phase of sleep where the body and muscles are completely relaxed. Because of this level of relaxation, there's usually little to no body movement during REM sleep.
然而, 伴有快速眼动睡眠行为障碍, 人的身体会对梦做出反应, 把梦中发生的事情表演出来. 这对病人和他们的床伴都是危险的. What Veater didn't know back in 2011—and what most patients don't know—is that this sleep disorder can be an early symptom of 帕金森病 and related disorders.
REM sleep behavior disorder can sometimes be experienced years before patients develop any other sign of 帕金森病. Many patients never bring up the fact that they have been acting out their dreams because they don't think it's a symptom of the disease, 因此是不相关的.
2015年初, 在被诊断为快速眼动睡眠行为障碍四年后, 维特的左脚开始颤抖. 然后，震颤从她的腿蔓延到她的手臂, 继续向她身体的另一侧扩散. “震动是痛苦的，”维特说. "My left arm was the worst—it ached all the time from the constant tremors."
尽管使用了许多不同的口服药物, 在接下来的六年里，维特的症状持续恶化. “我感到非常疲劳，”她说. “我不能在厨房里站着做饭. I'd start a meal and then would have to call my husband in to finish it. 我妈妈住在地下室, 看完她，我还得爬楼梯, 我太累了."
Her health deteriorated as she developed some of the other problems associated with 帕金森病. 随着时间的推移，她在某种程度上丧失了能力. On top of this, she experienced many negative side effects from the medications.
With her symptoms worsening and seeing little to no benefit from most of her medications, 保罗·莫雷蒂医学博士她的专家是 神经学 他是 认知神经病学分部 犹他健康大学的医生将她推荐给了约翰·D. 罗尔斯顿，医学博士，前专家 神经外科 也是 癫痫手术 随着 功能和立体定向神经外科 在大发娱乐.
At this point in Veater's journey, Rolston suggested surgical intervention with 深部脑刺激因为药物治疗已不足以控制她的症状. DBS is a surgical procedure in which electrodes are placed in the parts of the brain that cause tremors and other symptoms. These electrodes are connected to a pulse generator—the battery—in the upper chest. 然后电池为电极供电, 向大脑的特定区域发送电刺激, which can then ease or completely get rid of tremors and other symptoms.
“DBS已经获得fda批准近20年了, 成千上万的病人做过这个手术,罗尔斯顿说. “这是非常安全和微创的. Most patients see a significant improvement to the quality of their lives."
即使知道潜在的积极结果, Veater was scared and overwhelmed when she was first approached about this possible treatment plan. “当有人向我推荐星展银行时，我吓坏了，”她说. "To me, it was a scary, invasive surgery—brain surgery—and I didn't know if I could do that. 但随着我的症状越来越严重, I realized I needed to trust the recommendation of my doctors and consider having the surgery."
脑起搏术是一种专门的手术, and the state of Utah only has three 神经surgeons who are qualified to perform the surgery. 幸运的是维特, 其中两名在大发娱乐, 而他们中的一个——罗斯顿——最终为她做了手术.
罗尔斯顿和莫雷蒂的搭档 梅根·佐恩，宾州大学 in 神经学 制定综合治疗方案. Not every Parkinson's patient is eligible for DBS, as not each case of Parkinson's is created equal. Each patient is evaluated to ensure that they will benefit from the procedure, 根据他们的具体情况.
而脑起搏术并不能治愈帕金森症, 适合像Veater这样的病人, it can help control the symptoms and improve the physical and mental well-being of the patient. “在我的护理团队开会讨论我的病情之后, 他们让我知道我有资格做手术,维特说。. “我太兴奋了，我不再害怕了. My symptoms had gotten bad enough that nothing could be worse than where I was headed."
DBS是在两个独立的手术过程中完成的. 在第一个程序中, electrodes are implanted in the brain and attached to lead wires that are surgically implanted 在皮肤下 in the neck so they can reach the pulse generator—their power source.
The second procedure involves implanting the pulse generator—or battery—in the upper chest, 在皮肤下. 一旦开启, this device not only provides power to the electrodes but also controls the intensity of the stimulation that the patient's brain receives.
维特的手术分别在6月11日和6月23日进行. 不到一个月后, 7月13日, 佐恩打开设备，进行了初始编程. “当设备打开时，我所有的症状都消失了，”维特说. “这是一个奇迹，只要按一下开关. 虽然我还患有帕金森症，但那些不好的症状都消失了. 太神奇了. 我非常非常感谢. 罗尔斯顿,博士. 莫雷蒂和梅根·佐恩."
在最初的任命之后, 维特开始意识到这种治疗是如何改变他的生活的. “我意识到我不仅没有发抖，而且精力充沛，”她说. "I could go up and down the stairs to see my mom three times in a row without catching my breath. 直到我不再累了，我才意识到我有多累."
由于治疗的性质，DBS是高度可定制的. The pulse generator is programmed to meet the individual needs of each patient and can be adjusted over time. 在设备启动四周后, 维特再次与佐恩会面，对设备上的程序进行微调.
“我注意到在第一个月我是否真的很累或有压力, 我的手最轻微的颤抖都会开始,维特说。. “8月10日我第二次去的时候, Meghan fine-tuned the programming and upped the amplitude on the device. 从那以后，一切都很完美. But if I notice any other tremors, I can schedule an appointment to have the programming readjusted."
Veater continues to marvel at the change in her quality of life and her ability to do what she couldn't do before. 手术前，她不能自己穿衣，不能写字，也不能打字. 她现在可以毫无困难地做所有这些事情了.
“我亲爱的丈夫把我照顾得很好，”维特说. “现在我有很多事情要自己做. 我的生活又回来了."
所有帕金森氏症患者的评估标准都是通用的 统一帕金森病评定量表（UPDRS）这有助于追踪他们症状的严重程度. 症状越严重，分数越高. Since having the DBS device implanted, Veater's numbers have shown significant improvement.
在设备打开之前，Veater的UPDRS评分为50分. After the device was turned on and initial programming completed, her score was 18. And after the second round of programming on August 10—just a month after the device was turned on for the first time—her score was 10.
"The degree of improvement as measured by the UPDRS is impressive and confirms the effectiveness of DBS in controlling the patient's most disabling symptoms,莫雷蒂说. "Ms. 当设备未打开时，维特的得分高出5倍. 即使没有帕金森氏症的病人也能得到5分, 所以对于患有帕金森症的人来说，得到10分是很了不起的."
Many patients tend to balk at the idea of surgery, seeing it as a last resort treatment option. 然而, DBS surgery can be done as early as four years from a 帕金森病 diagnosis, provided that the patient meets other selection criteria for the surgery.
“大发娱乐看到很多病人想要等待做这个手术, 在疾病的晚期,莫雷蒂说. "Although surgery is considered a treatment of last resort in many cases, 星展银行的情况通常不是这样. Ms. 维特的结果是惊人的, and it could be that she has done so well with it because she didn't wait."
维特很感激她没有等. "I'm only 66 years old, and I have a husband, four kids, and 13 grandchildren to enjoy," she said. “我已经重获新生，我只是不能告诉你. There's no way to thank my health care team for all that they've done for me."