Parkinson’s cases in Brazil are expected to double in the coming decades, from about 500,000 to 1.2 million in 2060, according to a Brazilian study, published in April at The Lancet Regional Health. Researchers at the Federal University of Rio Grande do Sul (UFRGS) and other institutions estimated from data from almost 10,000 people in all regions of the country.
Despite this perspective, it also concludes that the disease is still very underdiagnosed in its early stages, signaling the need to improve case investigation and greater access to treatment.
O is a neurological disease caused by the degeneration of cells responsible for dopamine production, neurotransmitter involved in movement stimuli. The main risk factor is the, but studies also suggest an association with excessive exposure to certain chemicals, such as some solvents.
At first it manifests itself from tremors, slow movements, muscle stiffness, among other symptoms. The diagnosis is clinical, since there is no specific examination capable of detecting the disease, which is progressive and has a slow evolution.
Although there is no cure, treatment can help keep symptoms under control. In the early stages, therapeutic conduct is made with medicines to supply the lack of dopamine, as well as physical activity, physical therapy and, in some cases, speech therapy sessions.
However, after about seven or eight years, depending on each individual, functional limitations begin to appear. “There can be a big impact on quality of life and often the person is still active, needs to work, for example. At this stage, the advanced therapy is discussed,” explains neurologist Rubens Cury of Hospital Israelita Albert Einstein.
For those who no longer respond to clinical treatment, there are some treatment options, which should take into account the stage of the disease and the profile of each patient. Learn more about them:
1. DBS (Deep Brain Stimulation or Deep Cerebral Stimulation)
This surgical technique has been around for about 20 years and has great effectiveness in controlling slowness and tremors. The procedure involves the implementation of two electrodes in specific regions of the brain, one on each side.
They are linked to a kind of pacemaker implanted in the patient’s chest. This device emits an electric discharge that modulates the nucleus of sick cells, regulating the signs that produce the symptoms.
In addition to effectiveness, one of the advantages of the technique is the possibility of regulating intensity according to symptoms – as the disease progresses, it is possible to adjust discharges. On the other hand, because it is a surgical procedure, it can be contraindicated for some people, such as very elderly or with clinical complications.
2. High-Intensity Focused Ultrasound (HIFU)
It is a high intensity ultrasound indicated to control both Parkinson and a picture called essential tremor. It promotes an immediate improvement of this symptom, around 70%. The technique arrived in Brazil in 2025, but has been approved in the United States since 2017.
Unlike DBS, this procedure is less invasive. The patient is placed on a magnetic resonance imaging machine using a kind of helmet (for this, it is necessary to scrape all hair). With the help of image exams, intervention is planned at the exact location where cells are changed.
During the procedure, ultrasound waves are applied at a specific point of the brain, the talamus, responsible for tremors. The goal is to cause a tiny 4mm thermal injury that eliminates the “short circuit” causing the tremor. This whole process lasts about three hours and is done with the patient agreed without general anesthesia. The rise occurs on the same day.
The therapy is unilateral, that is, if the individual has tremors on both sides of the body, he can hold an additional session on the opposite side after at least nine months.
However, the technique is not a cure for the disease, nor does it eliminate symptoms such as stiffness and slowness. Although in the long run most continue with controlled tremors, they can come back. “It depends on the progression of the disease and the person. They may also not improve as much as the patient would like. They may have to repeat or do other treatments,” says Cury.
In addition, due to inflammation at the site of injury, the person may have difficulties in balance. There may also be pain, nausea, tingling, speech alteration and weakness. In the vast majority of cases, side effects are tolerable and passenger.
3. Dopaminergic infusion therapy
This treatment is nothing more than the infusion of the existing medicine through a subcutaneous bomb that constantly releases doses. Has been pointed out as an output for individuals with symptom fluctuations, alternating periods called on e off.
“Oral medicine has an effect, but then falls. These patients can benefit from this continuous therapy,” explains the neurologist. Although it was released in the United States in 2024, it has not yet been approved by the National Health Surveillance Agency (Anvisa).
