Preliminary remark by Prof. Citak: “When Parkinson’s disease is diagnosed, we doctors can decide for ourselves whether we want to carry out a therapy or not. This is just like many medications where patients are prescribed drugs that are actually approved for other indications. This is called “off-label therapy” and this is everyday life in medicine. In Parkinson’s, T. P. S. has been used very successfully for over 10 years in clinical trials, but Parkinson’s has yet to be approved as a single indication. My colleagues and I are very much looking forward to this, because in Parkinson’s, T. P. S. is also an absolute drug of choice.”
The prehistory: D. B. is an extremely pleasant and open-minded gentleman of 70 years, with whom one can chat so wonderfully extensively. He lives with his family in Lower Saxony, has two children and four grandchildren and leads what many would consider a perfect retired life. He retired at 65 and was looking forward to traveling with his wife, spending time with his grandchildren, and also wanted to go to the stadium more, because he is a big ice hockey fan. But life just can’t be planned. He has been quite healthy all his life, he has been a vegetarian or later vegan for over 30 years and takes good care of his health. Only in 2009, however, he experiences a strong herniated disc, which makes him long to create. But there, so in 2019, is at some point something: His left hand begins to tremble, only now and then, in stressful situations, for example, or even when he is positively excited: “When sitting in the ice hockey stadium, I had to at some point the hand under the thigh downright tight, so that it remains calm,” he tells in the conversation. He also keeps feeling a strangely cool tingling sensation in his left foot, which goes down his left leg and abdomen and up into his left arm: “I can’t really describe it, just a diffuse, unpleasant tingling sensation that started to frighten me,” reports D. B. Something is wrong. One goes to the doctor.
The family doctor immediately refers him to the neurologist and there the usual examinations begin: Brain wave measurements show signs but are not conclusive enough for a diagnosis, according to the neurologist. Various other tests and an initial MRI initially reveal nothing. But a few months later, a DaTSCAN is performed. This is a nuclear medical examination to check the functionality of certain nerve connections in the brain (brain receptors, so-called dopamine transporters) and to visualize them. And here the diagnosis is clear: Parkinson’s disease.
D. B. and the family are stunned: “It was such a shock,” says D. B. “Now I had this diagnosis and knew there was nothing medicine could do about it. It just makes your head spin, and not only that, it turns everything upside down.” The neurologist prescribes pramipexole, 0.26 mg a day initially, for him to take. D. B. and his family do not receive any further information or advice on what else to do. They are alone with the disease.
Pramipexole is a drug that is used as a standard treatment for Parkinson’s disease. As a so-called dopamine agonist, the drug mimics the effect of the naturally occurring neurotransmitter dopamine, which is produced in the healthy brain by dopamine-producing nerve cells. In the brain, dopamine is used for communication between nerve cells, i.e. it is a nerve messenger (neurotransmitter). In Parkinson’s disease, these cells are also damaged, leading to various disorders – not only motor, but also psychological (it is not for nothing that dopamine, like serotonin, is therefore commonly referred to as the “happiness hormone”).
But pramipexole does not help Mr. D. B. – quite the opposite. By taking it, at least that is how D. B. feels, the symptoms increase massively. The tingling and trembling become stronger and, almost worse, the fears, the insecurity, the indefinable pressure on the soul strike more and more. D. B. no longer has a quiet hour. The neurologist recommends doubling the dose. But D. B. refuses. He is on the Internet, he consults Dr. “Google” extensively. But everywhere the same: Parkinson’s is an incurable disease, the reports and lists of the symptoms and the unstoppable progression are pages long and unfortunately also very detailed; coolly and factually a journey of horror is described. And one can only keep the disease somewhat under control with medication, otherwise exercise and a healthy lifestyle are recommended. Just reading on the Internet for days brings D. B. to his lowest point. He reads about deep brain stimulation: in deep brain stimulation (THS), one or two electrodes inserted into the brain send electrical impulses to nerve cells that affect certain movements. This can relieve Parkinson’s symptoms, but it involves surgery, and what if the pacemakers get out of sync? No, that’s not an option for D. B. not an option.
Someone in the family happens to see the TV report about TPS . What is it, why do not know – it is the usual, as D. B. later learns. TPS is not yet widely known, only with the right search terms you can find it on the Internet. D. B. researches, the family discusses. Why doesn’t the neurologist know about it? But anyway, it is a piece of hope, an option. One informs oneself. Thank God, Prof. Dr. med. Musa Citak, the doctor from the television who works in Hamburg, has just opened a branch in Berlin! An appointment is made, the waiting time is quite long, but still manageable for D. B. still manageable, even if the emotional stress is hardly bearable.
D. So B. is going to Berlin in January 2022. The treatment with Transcranial Pulse Stimulation is pleasant and simple. Will it bring anything? After the second therapy unit, the effect begins: “I suddenly felt more balanced, somehow safer and freer, I can’t describe it in words very well,” D. B. tells: “This mental and also this emotional pressure, these fears gradually disappeared. I was finally able to breathe calmly and deeply again after years – in both senses of the word.” The tingling in the foot, over the abdomen and into the arm, the shivers of cold, also gradually disappear. Only the trembling of the left hand has not completely disappeared after the sixth treatment, but at least it occurs only rarely. And if it does? “I would rate the reduction around 50 to 60%,” says D. B. on the phone in mid-March and continues: “But you know, a healthy person can certainly not imagine how this disease also affects the nervous and mental situation. You are no longer yourself, your whole life is in the shadows. And that is almost completely gone! I can live with a little bit of trembling, and of course I hope that we will be able to get rid of it in time with further treatments. I am completely convinced by the therapy.”
In April, D. B. will be back in Berlin. There we will see how Transcranial Pulse Stimulation can continue to help him completely eliminate the tremors as well. We will continue to report on the case.
Note: After the 6-times treatment D. B. went to his neurologist again, who measured his brain waves and his left hand again – at least one year later. The neurologist formulated the result according to D. B. thus: “Strange, this should have worsened, but there everything is good.” Mr. D. B. said nothing to this. He looked for another neurologist in the meantime.