Brain 'pacemaker' offers hope to Parkinson's victims

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GRAHAM SANDERCOCK was only 37 when he developed Parkinson's disease. From leading an active life as a father of two and working as a painter and decorator, he found himself gradually losing control of his body, until he was unable to walk, unable to wash, unable even to eat.

Now 52, he contemplates the fist-sized mechanism that was attached to his collarbone in a five-hour operation. "I have got a new life. Now I can get out of bed by myself. I can wash myself, dress myself and go for a walk. I no longer need help during the day, and sleep well at night."

The cause of his happiness is a device that provides sufferers of Parkinson's disease with an on-off switch to control their symptoms - like a "pacemaker" for the brain - which was launched in Britain yesterday.

Using electrodes implanted deep in the brain and connected to a battery- powered transmitter, the novel treatment, called Activa, can ease or even wipe out the symptoms of the disease, which leaves sufferers shaking involuntarily or frozen in immobility.

The treatment - made by the American company Medtronic - could, in theory, help up to 20,000 of the 125,000 people diagnosed with Parkinson's disease in the UK every year. But its cost - pounds 5,000 for the device, pounds 7,000- pounds 10,000 for the operation to install it, and thousands more to maintain it - will count against it at a time when health spending is being pushed towards cutting waiting lists, and expensive therapies struggle for health managers' acceptance.

However, both the Parkinson's Disease Society and doctors who have pioneered the system say that, compared to price of expensive medication and long- term care, it could be cost-effective. Drugs for controlling the symptoms of Parkinson's disease can cost pounds 15,000 a year.

Most of those diagnosed as having Parkinson's disease are elderly, but the Activa therapy is seen as being chiefly of benefit to sufferers in their thirties or forties. Often, these patients find that drugs become less effective over the years and, as the dosage is increased, they can induce wild movements of the head.

Mary Baker, president of the European Parkinson's Disease Association, said it is vital to persuade those paying for health care to offer the therapy. "Nobody knows what Parkinson's disease is costing the country," she said. "We have to provide the evidence."

Parkinsonism is caused when brain cells making the neurotransmitter dopamine degenerate; the effect is loss of movement control. Surgical techniques involve burning away ineffective cells, but require great accuracy. Activa applies an electrical stimulus - thus avoiding the risks of burning a hole in the brain.

The transmitter is implanted near the collar bone, and the connecting wire and electrodes are also hidden under the skin. The patient uses a magnetic device to control the transmitter. Mr Sandercock finds that this is the only drawback: he cannot walk unchallenged through airport control or pass cutlery without it getting attached to him.