Cleveland Clinic Abu Dhabi surgeons during one of the surgeries. Image Credit: Supplied

Abu Dhabi: Four Emiratis living with Parkinson’s disease have become the first to benefit from deep brain stimulation (DBS) procedures conducted in the UAE.

The complex surgeries, which lasted between four and eight hours each, were carried out at the Cleveland Clinic Abu Dhabi, and aimed to improve patient’s symptoms and quality of life.

DBS is a neurosurgical procedure that places a medical device called a neurostimulator under the patient’s skin. The device then sends electrical impulses, through implanted electrodes, to specific targets in the brain for the treatment of movement disorders like Parkinson’s.

DBS surgery benefits

The Cleveland Clinic Abu Dhabi has been offering DBS treatment to control the electrical impulses since last year, but the four Emirati patients were the first to receive the electrode and neurostimulator implantation surgeries in the UAE. Evaluations for the procedures involve a multidisciplinary team of neurologists, neurosurgeons, physical therapists, speech therapists, and a neuropsychologist in order to cater to each patient’s specific needs, as each patient’s needs are markedly different from the next.

As a brain disorder, Parkinson’s leads to shaking, stiffness, and difficulty with walking, balance and coordination. A successful DBS procedure can reduce the symptoms that patients experience, thereby decreasing the need for medication and improving their quality of life.

“DBS will transform both the lives of patients and the way Parkinson’s disease is treated in the UAE. The level of expertise required to offer this surgery is phenomenal and I am proud of the whole team,” said Dr. Florian Roser, chair of the Neurological Institute at the hospital.

Surgical procedure

During the surgery, neurosurgeons implant electrodes into precise areas of the brain to block rogue signals that cause motor problems such as tremors. These areas are identified in advance using advanced imaging technologies that inform each patient’s unique surgical plan.

“DBS is a particularly complex endeavour that relies on detailed planning and submillimeter precision. Once identified, the challenge is to place the electrode at those precise points through the brain. Each case is unique and dramatically different to most surgeries,” said Dr. Tanmoy Maiti, the neurosurgeon who performed the surgeries at the Abu Dhabi-based hospital.

Collaboration with Ohio facility

The Abu Dhabi DBS programme has been set up under close collaboration with the Cleveland Clinic in Ohio, which has more than 20 years of experience in the field and sees more than 150 deep brain stimulation surgeries performed per year. The Cleveland Clinic Abu Dhabi surgical team received support in the UAE’s first deep brain stimulation surgeries from Dr. Andre Machado, institute chair at the Cleveland Clinic, Ohio, who flew to Abu Dhabi from the United States for the surgeries.

Patient selection

The Emirati patients chosen for the surgery were younger than an average group of patients with Parkinson’s disease, which is most common in people over the age of 60. However, a growing proportion of patients around the world are being diagnosed with early onset Parkinson’s disease, interfering with their family, social and work lives.

“Parkinson’s disease can have a tremendous impact on a person both physically and mentally. This is particularly true of early onset Parkinson’s that can affect people in the prime of their lives, depriving them of things many of us take for granted,” said Dr. Shivam Om Mittal, a neurologist specialised in Parkinson’s disease and movement disorders at the hospital.

Beneficiaries speak

This was particularly true for Mohammed Al Aryani, a 49-year-old who was diagnosed with Parkinson’s disease in 2003 at the age of 32. “I left my job, stopped my studies and even stopped leaving home for a long time. I wasn’t able to see my own children because I didn’t want them to see me like this. Now, after my surgery, I would like to continue my studies and get my bachelor’s degree. Most importantly, I cannot wait to be close to my children again,” Al Aryani said.

Rashed Alhebsi, another of the four patients, was diagnosed with Parkinson’s in 2015. “I could not move properly or go to work normally. My mental health deteriorated, and I could not socialise anymore. Now I look forward to becoming more active and socialising again,” Alhebsi said.