ABU DHABI //Patients with movement disorders have access to a surgical procedure that was previously only available abroad.
Sheikh Khalifa Medical City is the only hospital in the country to offer deep-brain stimulation, an operation that involves placing small electrodes in the brain to stimulate the areas responsible for motor function.
Deep-brain stimulation, or DBS, is approved by the US Food and Drug Administration for treating essential tremor, Parkinson's disease and dystonia.
It is recommended for patients who are no longer responding to medical treatment or can no longer tolerate the side effects of their drugs.
In Parkinson's patients, the procedure is performed while the patient is awake, to assess response.
The 1.2-millimetre electrodes are controlled by a stimulator placed just beneath the skin in the chest area, which can be adjusted wirelessly through a radio-frequency device.
Dr Maher Mansour, consultant neurosurgeon in brain and spine surgery at SKMC, said the procedure could take 12 hours because of its complexity.
"The difficulty of this procedure is in reaching a very small area in the deepest part of the brain," Dr Mansour said.
First, a series of MRI and CT scans localise the area. Five micro-electrodes are then inserted to record the electrical activity of the brain, as each area has its specific patterns.
Three of the closest electrodes are then used to test the effects of stimulation.
"In Parkinson's patients, you can immediately see the tremors stop," Dr Mansour said. "At the same time we can test for undesirable side effects."
If the electrode is too close to the motor track going from the brain to the peripheral muscles, the patient's muscles will contract. If it is too close to the nearby optical pathway, the patient will see flashes of light.
"The distance between the desirable effect and the undesirable effect is just one millimetre, which is the thickness of the electrode," Dr Mansour said. "It's all about precision. There's no room for error."
Finally, the micro-electrodes are replaced with the permanent electrodes and the same process is repeated for the other side.
At SKMC, the procedure costs about Dh230,000 and is typically not covered by insurance. Thiqa provides partial coverage for UAE nationals.
"It's new here and insurance companies are not familiar with it, although they would benefit in the long term," Dr Mansour said.
"A study in France showed that insurance companies got their money back from a Parkinson's disease patient who underwent DBS within 23 months of treatment because patients are hospitalised less, visit the doctor less and are on less medication."
Yet many patients still choose to travel abroad.
"There is a lack of awareness and there's also lack of trust, for sure, especially among the Emiratis," Dr Mansour said.
"We tell them we're educated abroad, we have our training and experience abroad, but they still insist - and the cost of sending a patient abroad is about 10 times the amount of treating them here."
The challenge in offering DBS at hospitals other than SKMC lies in finding qualified surgeons and the expenses involved, doctors said.
Rashid Hospital in Dubai treats about 100 Parkinson's patients, adding one or two each month.
Every year, the hospital sends about 10 patients abroad to receive DBS.
"Ten out of 100 is a good number and is worth the investment," said Dr Abubaker Al Madani, head of neurology at Rashid, who has developed a plan with his colleagues to launch a DBS centre in Dubai.
Although there are no figures on the prevalence of Parkinson's in the UAE, experts estimate it is similar to the worldwide rate of 1 per cent of people over age 60.
Part of the problem is the lack of data, said Omar El Agnaf, professor of biochemistry at UAE University.
"The first step to tackle any disease is to know the incidence, so epidemiological studies are very important to give us an idea where we are, what we are facing and then how to handle it," Prof El Agnaf said.
A series of studies partially funded by the Michael J Fox Foundation found the mutation of one particular gene accounted for between 30 and 40 per cent of Parkinson's cases in Morocco, Tunisia, Algeria and Libya.
Overall, genetics account for only 10 per cent of cases worldwide.
"This gives you a clear message that we have a unique population and maybe in the future, whatever treatment developed will be based on these findings," Dr El Agnaf said.
"We need clinical centres focusing on neurodegenerative diseases, to treat patients and do research.
"We need this for our own population because we are different and nobody will do it for us unless we do it for ourselves."
mismail@thenational.ae
How to protect yourself when air quality drops
Install an air filter in your home.
Close your windows and turn on the AC.
Shower or bath after being outside.
Wear a face mask.
Stay indoors when conditions are particularly poor.
If driving, turn your engine off when stationary.
COMPANY PROFILE
Name: Almnssa
Started: August 2020
Founder: Areej Selmi
Based: Gaza
Sectors: Internet, e-commerce
Investments: Grants/private funding
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The specs
Engine: 3.0-litre twin-turbo flat-six
Power: 480hp at 6,500rpm
Torque: 570Nm from 2,300-5,000rpm
Transmission: 8-speed dual-clutch auto
Fuel consumption: 10.4L/100km
Price: from Dh547,600
On sale: now
One in nine do not have enough to eat
Created in 1961, the World Food Programme is pledged to fight hunger worldwide as well as providing emergency food assistance in a crisis.
One of the organisation’s goals is the Zero Hunger Pledge, adopted by the international community in 2015 as one of the 17 Sustainable Goals for Sustainable Development, to end world hunger by 2030.
The WFP, a branch of the United Nations, is funded by voluntary donations from governments, businesses and private donations.
Almost two thirds of its operations currently take place in conflict zones, where it is calculated that people are more than three times likely to suffer from malnutrition than in peaceful countries.
It is currently estimated that one in nine people globally do not have enough to eat.
On any one day, the WFP estimates that it has 5,000 lorries, 20 ships and 70 aircraft on the move.
Outside emergencies, the WFP provides school meals to up to 25 million children in 63 countries, while working with communities to improve nutrition. Where possible, it buys supplies from developing countries to cut down transport cost and boost local economies.
UAE currency: the story behind the money in your pockets
Formula Middle East Calendar (Formula Regional and Formula 4)
Round 1: January 17-19, Yas Marina Circuit – Abu Dhabi
Round 2: January 22-23, Yas Marina Circuit – Abu Dhabi
Round 3: February 7-9, Dubai Autodrome – Dubai
Round 4: February 14-16, Yas Marina Circuit – Abu Dhabi
Round 5: February 25-27, Jeddah Corniche Circuit – Saudi Arabia
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Director: Kangana Ranaut
Stars: Kangana Ranaut, Anupam Kher, Shreyas Talpade, Milind Soman, Mahima Chaudhry
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Engine: 77.4kW all-wheel-drive dual motor
Power: 320bhp
Torque: 605Nm
Transmission: Single-speed automatic
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On sale: Now
Company Profile
Founder: Omar Onsi
Launched: 2018
Employees: 35
Financing stage: Seed round ($12 million)
Investors: B&Y, Phoenician Funds, M1 Group, Shorooq Partners
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How to avoid crypto fraud
- Use unique usernames and passwords while enabling multi-factor authentication.
- Use an offline private key, a physical device that requires manual activation, whenever you access your wallet.
- Avoid suspicious social media ads promoting fraudulent schemes.
- Only invest in crypto projects that you fully understand.
- Critically assess whether a project’s promises or returns seem too good to be true.
- Only use reputable platforms that have a track record of strong regulatory compliance.
- Store funds in hardware wallets as opposed to online exchanges.
COMPANY PROFILE
Founders: Alhaan Ahmed, Alyina Ahmed and Maximo Tettamanzi
Total funding: Self funded
Our legal consultants
Name: Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
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UAE currency: the story behind the money in your pockets
COMPANY PROFILE
Name: HyperSpace
Started: 2020
Founders: Alexander Heller, Rama Allen and Desi Gonzalez
Based: Dubai, UAE
Sector: Entertainment
Number of staff: 210
Investment raised: $75 million from investors including Galaxy Interactive, Riyadh Season, Sega Ventures and Apis Venture Partners
Killing of Qassem Suleimani
Andor
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The bio
Job: Coder, website designer and chief executive, Trinet solutions
School: Year 8 pupil at Elite English School in Abu Hail, Deira
Role Models: Mark Zuckerberg and Elon Musk
Dream City: San Francisco
Hometown: Dubai
City of birth: Thiruvilla, Kerala
The specs
Engine: 3.0-litre 6-cyl turbo
Power: 374hp at 5,500-6,500rpm
Torque: 500Nm from 1,900-5,000rpm
Transmission: 8-speed auto
Fuel consumption: 8.5L/100km
Price: from Dh285,000
On sale: from January 2022
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The Sand Castle
Director: Matty Brown
Stars: Nadine Labaki, Ziad Bakri, Zain Al Rafeea, Riman Al Rafeea
Rating: 2.5/5
Inside%20Out%202
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Paatal Lok season two
Directors: Avinash Arun, Prosit Roy
Stars: Jaideep Ahlawat, Ishwak Singh, Lc Sekhose, Merenla Imsong
Rating: 4.5/5
Our legal consultants
Name: Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
German intelligence warnings
- 2002: "Hezbollah supporters feared becoming a target of security services because of the effects of [9/11] ... discussions on Hezbollah policy moved from mosques into smaller circles in private homes." Supporters in Germany: 800
- 2013: "Financial and logistical support from Germany for Hezbollah in Lebanon supports the armed struggle against Israel ... Hezbollah supporters in Germany hold back from actions that would gain publicity." Supporters in Germany: 950
- 2023: "It must be reckoned with that Hezbollah will continue to plan terrorist actions outside the Middle East against Israel or Israeli interests." Supporters in Germany: 1,250
Source: Federal Office for the Protection of the Constitution
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MOST%20POLLUTED%20COUNTRIES%20IN%20THE%20WORLD
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Our legal columnist
Name: Yousef Al Bahar
Advocate at Al Bahar & Associate Advocates and Legal Consultants, established in 1994
Education: Mr Al Bahar was born in 1979 and graduated in 2008 from the Judicial Institute. He took after his father, who was one of the first Emirati lawyers
COMPANY PROFILE
Name: Mamo Year it started: 2019 Founders: Imad Gharazeddine, Asim Janjua Based: Dubai, UAE Number of employees: 28 Sector: Financial services Investment: $9.5m Funding stage: Pre-Series A Investors: Global Ventures, GFC, 4DX Ventures, AlRajhi Partners, Olive Tree Capital, and prominent Silicon Valley investors. German intelligence warnings
- 2002: "Hezbollah supporters feared becoming a target of security services because of the effects of [9/11] ... discussions on Hezbollah policy moved from mosques into smaller circles in private homes." Supporters in Germany: 800
- 2013: "Financial and logistical support from Germany for Hezbollah in Lebanon supports the armed struggle against Israel ... Hezbollah supporters in Germany hold back from actions that would gain publicity." Supporters in Germany: 950
- 2023: "It must be reckoned with that Hezbollah will continue to plan terrorist actions outside the Middle East against Israel or Israeli interests." Supporters in Germany: 1,250
Source: Federal Office for the Protection of the Constitution
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Director: Shankar
Stars: Ram Charan, Kiara Advani, Anjali, S J Suryah, Jayaram
Rating: 2/5
The specs
AT4 Ultimate, as tested
Engine: 6.2-litre V8
Power: 420hp
Torque: 623Nm
Transmission: 10-speed automatic
Price: From Dh330,800 (Elevation: Dh236,400; AT4: Dh286,800; Denali: Dh345,800)
On sale: Now
