Trading Vulnerabilities: Living with Parkinson’s Disease before and after Deep Brain Stimulation

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Abstract

Implanted medical devices—for example, cardiac defibrillators, deep brain stimulators, and insulin pumps—offer users the possibility of regaining some control over an increasingly unruly body, the opportunity to become part “cyborg” in service of addressing pressing health needs. We recognize the value and effectiveness of such devices, but call attention to what may be less clear to potential users—that their vulnerabilities may not entirely disappear but instead shift. We explore the kinds of shifting vulnerabilities experienced by people with Parkinson’s disease (PD) who receive therapeutic deep brain stimulators to help control their tremors and other symptoms of PD.

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The prevalence of Parkinson's disease: a systematic review and meta-analysis.

Tamara Pringsheim, Nathalie Jetté, Alexandra Frolkis … (2014)

Parkinson's Disease (PD) is a common neurodegenerative disorder. We sought to synthesize studies on the prevalence of PD to obtain an overall view of how the prevalence of this disease varies by age, by sex, and by geographic location. We searched MEDLINE and EMBASE for epidemiological studies of PD from 1985 to 2010. Data were analyzed by age group, geographic location, and sex. Geographic location was stratified by the following groups: 1) Asia, 2) Africa, 3) South America, and 4) Europe/North America/Australia. Meta-regression was used to determine whether a significant difference was present between groups. Forty-seven studies were included in the analysis. Meta-analysis of the worldwide data showed a rising prevalence of PD with age (all per 100,000): 41 in 40 to 49 years; 107 in 50 to 59 years; 173 in 55 to 64 years; 428 in 60 to 69 years; 425 in 65 to 74 years; 1087 in 70 to 79 years; and 1903 in older than age 80. A significant difference was seen in prevalence by geographic location only for individuals 70 to 79 years old, with a prevalence of 1,601 in individuals from North America, Europe, and Australia, compared with 646 in individuals from Asia (P < 0.05). A significant difference in prevalence by sex was found only for individuals 50 to 59 years old, with a prevalence of 41 in females and 134 in males (P < 0.05). PD prevalence increases steadily with age. Some differences in prevalence by geographic location and sex can be detected. © 2014 International Parkinson and Movement Disorder Society.

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A history of deep brain stimulation: Technological innovation and the role of clinical assessment tools

John W Gardner (2013)

Deep brain stimulation involves using a pacemaker-like device to deliver constant electrical stimulation to problematic areas within the brain. It has been used to treat over 40,000 people with Parkinson’s disease and essential tremor worldwide and is currently undergoing clinical trials as a treatment for depression and obsessive–compulsive disorder. This article will provide an historical account of deep brain stimulation in order to illustrate the plurality of interests involved in the development and stabilization of deep brain stimulation technology. Using Latour’s notion of immutable mobiles, this article will illustrate the importance of clinical assessment tools in shaping technological development in the era of medical device regulation. Given that such tools can serve commercial and professional interests, this article suggests that it is necessary to scrutinise their application in research contexts to ensure that they capture clinical changes that are meaningful for patients and their families. This is particularly important in relation to potentially ethically problematic therapies such as deep brain stimulation for psychiatric disorders.

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Brain-computer interface-based control of closed-loop brain stimulation: attitudes and ethical considerations

Darin Dougherty, Alik S. Widge, Eran Klein … (2016)

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Author and article information

Journal

Title: Cambridge Quarterly of Healthcare Ethics

Abbreviated Title: Camb Q Healthc Ethics

Publisher: Cambridge University Press (CUP)

ISSN (Print): 0963-1801

ISSN (Electronic): 1469-2147

Publication date Created: October 2021

Publication date (Electronic): October 27 2021

Publication date (Print): October 2021

Volume: 30

Issue: 4

Pages: 623-630

Article

DOI: 10.1017/S0963180121000098

PubMed ID: 34702406

SO-VID: b4477d5f-debc-4dfa-8b3a-28a2d7308198

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https://www.cambridge.org/core/terms

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