Understanding the Hidden Symptoms of Parkinson’s Disease
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- Non-motor symptoms such as anxiety and depression can appear years before a Parkinson’s diagnosis.
- At 62, Veronica Brown shares her personal journey with Parkinson’s disease.
- Years after starting medication, Brown found relief through deep brain stimulation.
For over a decade, Veronica Brown dealt with chronic fatigue, anxiety, and profound depression, all without understanding their cause.
“I stopped traveling, and I used to be a travel agent,” she shared.
Unbeknownst to her, Brown was experiencing the non-motor symptoms of Parkinson’s during what is known as the prodromal or hidden stage of the illness.
Dr. Alessandro Di Rocco, a neurologist at Northwell Lenox Hill Hospital, explained that the brain begins to lose dopamine-producing cells years before motor symptoms like tremors, stiffness, and slowness manifest.
“Many individuals can look back and recognize mood changes, depression, or anxiety a few years before developing any motor symptoms. Some might even experience constipation, which is so common that it often goes unnoticed,” he told Healthline.
In 2018, while in her late 50s, Brown started noticing tremors in her foot, which ultimately led her to leave her retail job. Over the following years, additional symptoms emerged, including a slower walking pace and a hunched posture.
In 2020, she received a Parkinson’s disease diagnosis.
After coming to terms with her diagnosis, Brown began taking carbidopa-levodopa, a medication that promotes dopamine and is commonly used to treat motor symptoms of Parkinson’s disease. This medication, developed in the late 1960s, is regarded as a major medical breakthrough.
“It worked until it didn’t,” Brown recalled. “[The symptoms] just seemed to come on all at once, faster and faster.”
While the medication provided temporary relief, it eventually became inconsistent. Dr. Francisco Ponce, a neurosurgeon and chief of stereotactic and functional neurosurgery at The Barrow Neurological Institute, noted that over time, the benefits of medication can diminish, leading to a need for more frequent doses.
“Patients often find themselves taking increased amounts of medication, with their Parkinson’s symptoms fluctuating throughout the day, resembling a roller coaster ride,” he explained to Healthline.
After three challenging years on medication, Brown opted for
“DBS therapy allows patients to gain better and more predictable control over their symptoms, minimizing fluctuations and dyskinesias. Additionally, many patients can significantly reduce their medication intake with DBS,” said Ponce.
Brown was referred to Ponce by her Parkinson’s specialist. At that time, she was taking medications seven to nine times daily. Although she had a history of responding well to medication, she was suffering from dyskinesias (involuntary movements) and significant fluctuations in her symptoms.
“Despite these challenges, we were able to measure a 50% improvement in Veronica’s symptoms with medication, indicating a good prognosis for DBS,” Ponce noted.
In January 2024, Brown underwent two DBS surgeries. While DBS has been an FDA-approved treatment for Parkinson’s disease for over two decades, Brown became one of the first patients globally to receive the latest Medtronic neurostimulation technology, Percept RC.
“This device is the smallest and thinnest option currently available, making it an excellent fit for Veronica’s petite frame,” Ponce explained.
The procedures were performed while Brown was under anesthesia, which helped alleviate some of her anxiety. The first activation of her DBS occurred on January 30.
Post-surgery, Brown enjoyed more consistent symptom control, fewer fluctuations, and a reduced need for medication and dyskinesias.
“I was incredibly fortunate; it worked for me. One morning, I woke up, came downstairs, and thought, ‘I’m going to bake some cookies,’” she recalled. “Everyone looked at me in disbelief.”
This was a spark of excitement and energy her family had not seen in years.
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Despite the proven benefits of DBS, there can be hesitance surrounding this brain surgery.
“Our mission is to enhance awareness through outreach and education, highlighting that this is a data-supported therapy that significantly improves quality of life in Parkinson’s patients,” Ponce stated.
He hopes to encourage more individuals to consider DBS, especially since the surgeries are now more comfortable and less stressful than in the past.
“While it may seem overwhelming to undergo major surgery, many patients are awake during their brain surgeries,” Ponce explained.
Did you know that Deep Brain Stimulation (DBS) can be performed safely while patients are either awake or under anesthesia? This flexibility can help alleviate some of the fears associated with surgery.
Dr. Di Rocco pointed out that only 4% of eligible patients actually proceed with the DBS procedure. This low figure can be attributed to age, pre-existing medical conditions that elevate surgical risks, and cognitive changes in patients.
Sometimes, individuals who could greatly benefit from DBS may develop cognitive issues, making them ineligible for the surgery. Moreover, not all neurosurgeons possess the necessary training or resources to perform DBS.
Fortunately, patients like Brown who qualify for DBS are grateful for the chance to improve their lives. Brown, who only bears a small scar from her procedure, credits her husband and her fellow Parkinson’s patients for their unwavering support throughout her journey.
Connecting with a supportive community of individuals who have similar experiences can be incredibly helpful. Brown stresses the importance of sharing insights and advice within these groups, as each person offers a distinct perspective.
In fact, Brown learned about DBS through a support group, where another patient shared their experience. Hearing first-hand stories and advice from those living with Parkinson’s can provide invaluable reassurance for anyone contemplating DBS surgery.
