Deep Brain Stimulation
Deep Brain Stimulation, also known as DBS, is the most advanced and effective surgical treatment available to help people suffering from Parkinson’s disease, Essential Tremor and Dystonia. While there is no known cure for these neurological conditions, DBS can significantly reduce symptoms and improve a person’s quality of life.
What is DBS and How does it work?
DBS uses a surgically implanted device, similar to a cardiac pacemaker, called an internal pulse generator (IPG) or neurostimulator to deliver electrical stimulation to precisely targeted structures in the brain that are involved in motor control. Stimulation of these structures works like a sort of “brain pacemaker” interfering with the signals that cause some of the disabling movements. This interference results in greater control over your body movements. The electrical stimulation is delivered through a lead or electrode. The entire system is implanted completely inside the body and depending on your condition you may have multiple electrodes and one or two IPGs (Battery). The IPG is implanted just below the collarbone. The neurostimulator can be adjusted as needed for optimum symptom control.
Where are the electrodes inserted?
Electrode targets in the brain are decided based upon your condition and type of symptoms needed to be treated. Currently most commonly used sites for DBS include, Subthalamic nucleus (STN), Globus pallidus internus (Gpi) and Ventral Intermediate nucleus (Vim).
When is DBS needed?
Parkinson’s Disease (PD) If you are a patient with PD, DBS surgery may be considered when medication and/or other treatment strategies do not work to relieve your symptoms. You may be considered for surgery when you are experiencing disabling disease symptoms such as tremor, stiffness, slowness of movement, or abnormal movements induced by treatment that interfere with your ability to carry out your activities of daily living.
If you are a patient with Tremor, DBS surgery may be considered when medication and/or other tremor control strategies have been tried and do not work. You may be considered for surgery when you are experiencing disabling tremor symptoms that interfere with your ability to carry out your activities of daily living.
If you are a patient with Dystonia, DBS surgery may be considered when medication and/or other treatment strategies such as Botox injections do not work to relieve your symptoms. You may be considered for surgery when you are experiencing severe symptoms such as pain and/or contractions that interfere with your ability to carry out your activities of daily living.
What are the advantages with DBS?
The procedure is entirely reversible and does not destroy brain tissue. Significant reduction in the occurrence of tremors, stiffness and slow muscle function. Reduction in medication-induced dyskinesia, motor fluctuations, gait disturbance and balance problems. Medication “on-time” typically increases and medication use decreases by as much as 50%. Essential Tremor patients can experience up to a 90% reduction in tremor, often with subsequent reduction or discontinuation or reduction of medication. Patients with Dystonia see significant improvement in involuntary muscle contraction. What are the risks associated with DBS? Overall DBS is a safe procedure with minimal associated risk. The surgery carries the same risks associated with any other neurosurgical procedure including bleeding, infection, neurological deficits and pain at the surgery sites.