Understanding Non-Motor Symptoms of Parkinson’s Disease
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- Non-motor symptoms such as anxiety and depression can occur years before a Parkinson’s disease diagnosis.
- 62-year-old Veronica Brown shares her journey with Parkinson’s disease.
- Brown found relief through deep brain stimulation after years of medication.
For over a decade, Veronica Brown faced chronic fatigue, anxiety, and depression without understanding the underlying cause.
“I stopped traveling, and I used to be a travel agent,” she recalled.
Unbeknownst to her, Brown was experiencing the non-motor symptoms typical of Parkinson’s disease during its early, often hidden phase.
Dr. Alessandro Di Rocco, a neurologist at Northwell Lenox Hill Hospital, explained that the brain begins losing dopamine-producing cells long before physical symptoms like tremors, stiffness, and slowed movements emerge.
“Many people can reflect back a few years prior to experiencing a tremor and recognize that they had mood changes, depression, or anxiety. Some might even face constipation, but it’s so common that it’s hard to link it to Parkinson’s disease,” he shared with Healthline.
In 2018, while in her late 50s, Brown noticed tremors in her foot, which led her to leave her retail job. Over the next couple of years, she experienced a decline in her physical abilities, including slower walking and a hunched posture.
By 2020, she received a diagnosis of Parkinson’s disease.
After coming to terms with her diagnosis, Brown started taking carbidopa-levodopa, a dopamine enhancer commonly prescribed for managing motor symptoms of Parkinson’s disease, which has been a significant medical advancement since its development in the late 1960s.
“It worked until it didn’t,” Brown reflected. “[The relief] seemed to diminish suddenly, and all my symptoms were returning rapidly.”
While the medication provided temporary relief, it eventually became inconsistent. This is a common experience, according to Dr. Francisco Ponce, a neurosurgeon and chief of stereotactic and functional neurosurgery at The Barrow Neurological Institute.
He noted that as time passes, the effectiveness of medications often diminishes, and complications can arise, resulting in uncontrolled symptoms.
“As a result, patients frequently find themselves increasing their medication doses, leading to fluctuating control over their symptoms throughout the day, akin to a roller coaster ride,” he told Healthline.
After three years of navigating her symptoms with medication, Brown sought
“Deep brain stimulation therapy provides patients with more stable and predictable symptom control, reducing fluctuations and involuntary movements. Many patients can also significantly decrease their medication levels post-DBS,” explained Ponce.
Brown was referred to Dr. Ponce by her Parkinson’s specialist. At that time, she was taking medication seven to nine times daily. Despite her positive response to medication, she was struggling with erratic movements and severe fluctuations in her symptoms throughout the day.
“Nonetheless, we found that Veronica’s symptoms improved by 50% with medication, indicating a likely favorable response to DBS,” Ponce noted.
In January 2024, Ponce performed two DBS surgeries on Brown. Although DBS has been an approved treatment for Parkinson’s for over two decades, Brown was among the first patients globally to receive the latest Medtronic neurostimulation technology, Percept RC.
“It’s the smallest and thinnest option currently available, which was particularly suitable for Veronica given her petite frame,” Ponce added.
The procedures were conducted while Brown was under anesthesia, easing her anxiety. The first activation of her DBS occurred on January 30.
Post-surgery, Brown experienced more consistent symptom control with fewer fluctuations and a decrease in her medication needs and involuntary movements.
“I was incredibly fortunate; it worked for me. One morning, I woke up, came downstairs, and said, ‘I’m going to bake some cookies,’” she recalled. “Everyone just looked at me like, what is she doing?”
It had been years since her family had witnessed her display such enthusiasm and energy.
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While DBS is FDA approved and studies demonstrate its effectiveness for Parkinson’s disease, many individuals remain hesitant to pursue it due to the nature of brain surgery.
“Our mission is to raise awareness about this data-backed therapy that significantly enhances the quality of life for patients with Parkinson’s disease through outreach and education,” Ponce explained.
He hopes that increased understanding will encourage more individuals to consider DBS, especially since modern techniques have made surgeries less daunting and more comfortable than in the past.
“It might be hard to fathom undergoing major surgery while awake, but this is often the norm for patients requiring brain surgeries,” Ponce remarked.
Did you know that Deep Brain Stimulation (DBS) procedures can now be safely performed while patients are either awake or under general anesthesia? This flexibility can alleviate some concerns that individuals may have regarding surgery.
Dr. Di Rocco noted that only 4% of eligible patients actually proceed with the DBS procedure. This low rate may be due to factors like age, pre-existing medical conditions that heighten surgical risks, and cognitive changes in patients.
Sometimes, individuals who could benefit from DBS may have developed cognitive issues, making them unsuitable for the procedure. Additionally, not all neurosurgeons possess the required training or resources to perform DBS surgery.
Fortunately, patients like Brown who are candidates for DBS surgery are grateful for their opportunities. Brown, who has just a small scar from the procedure, attributes her success to the unwavering support of her husband and fellow Parkinson’s patients throughout her journey.
Finding a supportive community of individuals with similar experiences can be incredibly advantageous. Brown highlights the importance of sharing experiences and advice within these groups, as everyone brings a unique viewpoint.
In fact, it was through a support group that Brown learned about DBS from another patient. Hearing firsthand experiences and insights from others living with Parkinson’s can offer invaluable reassurance to those contemplating DBS surgery.
