AGH neurosurgeon may have breakthrough on Parkinson's

| Thursday, Sept. 8, 2011

Dr. Peter Jannetta wasn't necessarily searching for a breakthrough in the treatment of Parkinson's disease as he prepared a patient for surgery to relieve the intense facial pain that had plagued her for more than a decade.

But the renowned Allegheny General Hospital neurosurgeon couldn't ignore what he saw four years ago as he reviewed the MRIs made of the 60-year-old woman's brain.

"As I looked at her scans, I noticed this artery pressing against an area known as the cerebral penduncle, where we know Parkinson's originates," Jannetta said Wednesday. "Then a light bulb went off. In addition to facial pain, the woman was suffering from Parkinson's.

"So I became curious about whether the artery just might be the cause of the disease."

With permission from the woman's family, Jannetta repositioned the offending artery while performing the surgical procedure he pioneered to relieve the facial pain.

Within days of surgery, the Parkinson's symptoms -- hand tremors, muscle rigidity, uncertain steps and immobile expression -- vanished. An estimated 1 million people in the United States suffer from Parkinson's disease.

"Up until now, we've only been able to treat the symptoms of Parkinson's, but not the source," said Jannetta, 79. "My instincts are that we were on the verge of something."

A subsequent study of MRIs made of 20 people suffering from Parkinson's and 20 healthy patients in a control group found that 78 percent of those with the disease had the same arterial conditions as the woman Jannetta treated.

"Although we clearly need to continue our research on a larger scale to substantiate this remarkable observation, the very idea that a manageable vascular abnormality in the brain may be a critical factor in disease onset and manifestation for some Parkinson's patients is an extremely exciting possibility," Jannetta said.

Detailed results of the study conducted by a team of physicians and neuroscientists led by Jannetta will be published today in the medical journal, Neurology International.

Dr. Daniel Truong, founder of the Parkinson's & Movement Disorder Institute in Long Beach, Calif., said while he thinks Jannetta's findings are "very interesting," he believes it is "too early" to say whether they will contribute to a cure.

"Additional research is certainly warranted," said Truong, who has been practicing neurology for more than 20 years. "But we need to take a cautious approach and not rush to any conclusions until the pathology has been proven."

Later this year, clinical trials to examine Jannetta's findings will be conducted at medical facilities around the country in the hopes of speeding up use of the procedure.

"It's not uncommon for it take as long as 20 years for new medical procedures to gain acceptance," Jannetta said. "My hope is that by conducting trials at multiple institutions we will be able to reduce that to two or three years."

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