Treatment of advanced Parkinson's disease

Currently, deep brain stimulation is the most commonly used invasive treatment method in the world. We were the first hospital in Finland to implement the directional electrode, which helps us to reduce adverse effects associated with deep brain stimulation, such as speech difficulties.

In deep brain stimulation, the electrodes, wires, and the generator are placed under your skin. When necessary, you can adjust the stimulator with your programmer device. However, once the optimization settings have been configured, no daily maintenance is required for the device.

Deep brain stimulation reduces tremor, motor fluctuations, and involuntary movements significantly better than optimized medicinal therapy. At best, the response lasts for over 10 years. We usually perform the procedure under general anesthesia. 

For more information on deep brain stimulation, visit the Brain Hub of the online Health Village.

Levodopa infusion therapy involves administering levodopa—the most commonly used medication for Parkinson’s disease—directly into the intestines or subcutaneous tissue.

You can adjust the infusion rate. Levodopa infusion has been shown to significantly reduce daily off-phases and increase on-phases when compared to regular medication. “Off” time refers to a period when symptoms worsen.

This treatment is useful for patients with motor fluctuations or involuntary movements who still clearly respond to levodopa treatment. Based on our experience, the treatment is effective for at least 10 years at its best.

For more information on levodopa infusion therapy, visit the Brain Hub of the online Health Village (Terveyskylä web service currently only in Finnish).

Apomorphine is a dopamine agonist which, despite its name ending in “morphine,” has no opiate effects—that is, it does not have a sedative effect on the central nervous system. Apomorphine alleviates motor symptoms about as much as levodopa does. The effects of an apomorphine injection—that is, an injection administered subcutaneously using an apomorphine pen—begin quickly, within as little as 10 minutes.

In an apomorphine infusion, we administer the medication subcutaneously using an infusion pump. Infusions have been shown to significantly reduce daily off-phases. It is particularly optimal if the apomorphine pen works well for you and if you need more than five injections a day. We can also proceed directly to an infusion without using the pen.  

Both levodopa and apomorphine infusions may be suitable options if deep brain stimulation is not suitable for you. For example, if levodopa does not help with balance or speech problems, or if you are afraid of the risks associated with brain surgery.