We understand how Parkinson’s disease affects each patient. Your care team will tailor an effective treatment plan to your needs. The OHSU Brain Institute offers one of the largest movement disorder programs in the United States.

You’ll find:

• A team of specialists to help you live well with Parkinson’s.
• International experts on Parkinson’s disease.
• A rare Next Step Clinic to help you and your family maintain your quality of life.
• A neurological rehabilitation team to help control symptoms and keep you active.
• One of the world’s pioneers in deep brain stimulation surgery.
• A commitment to research that leads to improvements in care.

Team-based care

Your care team: We offer a team approach to care, with specialists working together. Your team may include neurologists, physician assistants, nurses, physical therapists, speech and occupational therapists, and others. All have extensive expertise in caring for patients with Parkinson’s disease.

Patient navigators: Our nurses and physician assistants will answer your questions and help guide you through treatment. A neurology social worker can help you overcome barriers to care.

Rehabilitation experts: Your doctors will work closely with your neurologic rehabilitation team in our state-of-the-art rehab center. For Parkinson’s patients, care may include an innovative exercise program to slow symptoms.

Weekly conference: If needed, your care team will discuss your case with additional specialists, such as from orthopaedics, in a weekly videoconference.

Helping you prepare: Our Next Step Clinic, among only a half-dozen in the world, brings providers together when you need more help. The team includes a neurologist, physical therapist, nurse and social worker. They can meet with you and your family to relieve symptoms and stress. They can also help you prepare for advanced care. You’ll leave your appointment with a detailed plan and recommendations. Learn more about the Next Step Clinic.

Diagnosis

Your care team will use several tools to make a diagnosis. They may include:

Physical exam: You’ll receive a thorough exam from a movement disorders specialist. The doctor will ask about your medical history and symptoms. Two of these must be present for a Parkinson’s diagnosis:

• Resting tremor (uncontrollable shaking)
• Rigidity (akinesia)
• Slow movement (bradykinesia)
• Imbalance

Blood tests: These can rule out other conditions. They also measure a nerve protein that can help us see whether you have Parkinson’s or another form of parkinsonism. Blood tests can also identify genetic markers linked to Parkinson’s disease.

DaTscan: This advanced imaging shows the part of the brain that makes dopamine, a brain chemical that plays a key role in movement and Parkinson’s. OHSU was the first health center in Oregon to offer DaTscan (short for dopamine transporter scan).   

Sleep studies: These can spot a sleep disorder called REM sleep behavior disorder. RBD causes people to act out their dreams in deep sleep. People with RBD are much more likely to develop Parkinson’s disease, though researchers don’t know why.

Diet and exercise

Patients with Parkinson’s have less dopamine, a brain chemical that signals nerves to trigger movement. Exercise, along with a balanced diet and enough water, can increase dopamine.

Your doctor may refer you to a dietitian or nutritionist, or recommend a local community nutrition program. OHSU’s neurological rehabilitation team, with training in Parkinson’s disease, can help you stay active.

Rehabilitation

Early treatment with rehabilitation therapists trained in Parkinson’s is an important part of a complete care plan.

At OHSU, we offer specially trained physical, occupational and speech therapists. They can help you ease symptoms, maintain and improve function, and continue doing the activities you love.

Our neurologic rehabilitation team is available to help:

• Early in the disease
• As you have more symptoms, such as imbalance and tremors
• When your medications change

Medication

Your care team may recommend medications as the disease progresses. These may include:

• MAO (monoamine oxidase) inhibitors to slow the breakdown of dopamine. These are often the first medications we use.
• Dopamine agonists, which trick the brain into thinking more dopamine is available.
• Dopamine replacement, such as levodopa, which converts into dopamine. Doses may increase as symptoms progress.
• Duopa, a gel delivered by a pump through a thin tube into the small intestine over 16 hours.

Therapeutic toxin injection

You may benefit from an injection of botulinum toxin (Botox is one example), a neurotoxin made from a naturally occurring protein. These block nerve signals to overactive muscles, relaxing the muscles to relieve symptoms. Injections into saliva-producing glands, for example, can greatly reduce saliva and drooling.

In our neurotoxin injection clinic, your doctor will identify muscles that are over-contracting and inject an appropriate amount of toxin. This technique requires years of expertise to master. Our doctors are among the most experienced in the country.

Also known as chemodenervation, these injections:

• Ease spasms
• Provide relief for three months

Focused ultrasound

If your tremor symptoms are worse or advancing faster on one side than the other, then focused ultrasound may be an option for you. This incisionless surgery ablates (burns) the exact part of your brain that is causing your tremor without an incision.

This treatment is a good alternative to deep brain stimulation for patients who take blood thinners or do not want to have invasive brain surgery.

Deep brain stimulation surgery

As Parkinson’s disease progresses, deep brain stimulation surgery may become an option. Our team is one of the most experienced in the United States. Under the direction of Dr. Delaram Safarpour, Dr. Kim Burchiel, an OHSU neurosurgeon, pioneered “asleep” DBS so you don’t have to be awake during surgery.

For this procedure, our team places tiny electrodes in your brain. The electrodes are connected to a small pacemaker-like device placed under the skin of your chest. The device sends mild electrical pulses to regulate movement and control Parkinson’s symptoms such as:

• Tremors
• Rigidity
• Slowness
• Imbalance

In some parts of the state, you can have follow-up care at a doctor’s office in your community.

Colin Halstead had deep brain stimulation surgery at OHSU to treat his Parkinson’s. “It gave me my life back,” he says.

Clinical trials

We offer a range of clinical trials to test promising new treatment approaches for Parkinson’s disease. Your care team will walk with you about whether a trial is right for you. Learn more about our research and clinical trials.