Deep Brain Stimulation or DBS as it is commonly called is a surgical treatment for people with certain types of Parkinson’s. It greatly helps in significantly improving the movement ability.
Deep brain stimulation (DBS) helps control movement symptoms of Parkinson’s – tremor (shaking), slowed movement (bradykinesia), and stiffness (rigidity). When medications aren’t as effective as they used to be and your symptoms make everyday life a challenge, DBS may help.
Deep brain stimulation uses a small, pacemaker-like device, placed under the skin of the chest, to send electronic signals to an area in the brain that controls movement. To give you relief, these signals block some of the brain messages that cause the movement symptoms of Parkinson’s.
How Deep Brain Stimulation helps
Deep brain stimulation helps control your movement symptoms when your medications aren’t working as well as they used to. For many people with Parkinson’s, Deep brain stimulation makes a difference when even small tasks have become challenging. Deep brain stimulation has helped some people stay as independent as possible and keep doing the activities they love.
While some people believe deep brain stimulation treats tremor (shaking) only, Deep brain stimulation also treats other movement symptoms of Parkinson’s disease – slowed movement (bradykinesia) and stiffness (rigidity).
At this point, you may be scheduling activities for the time during the day when the medications tend to be working better. You may have a narrow window for all that you need and want to do – like driving to the store or having lunch with a friend. With Deep brain stimulation, some people have been to able to get back to planning their lives around what they want to do at whatever time, rather than time them around their medications.
Symptom control may help you continue to do what’s important to you, like taking care of family or continuing to work. Or participate more fully in an event like a vacation or a family wedding.
the DBS system requires no daily cleaning or refilling; you can bathe and shower without worrying about your device; and you don’t have to carry or refrigerate supplies when away from home.
When to start Deep brain stimulation
As Parkinson’s progresses over time, many people have to take more medications more often. It can get hard to keep track of all the doses. The medications can also cause side effects like nausea, dizziness, and unintended movements (dyskinesia).
DBS Therapy may reduce Parkinson’s medication. This may reduce medication-related side effects like unintended movements. Less medication may also simplify your medication routine, with fewer pills or less frequent doses.
Unlike some surgeries for Parkinson’s, deep brain stimulation is reversible. The system can be turned off or removed, and won’t limit your future treatment options.
The right time for Deep brain stimulation is when your medications still work, but not as well as they used to.
Watch for these signs that your medications are not working as well as they used to:
- You have movement symptoms like tremor and stiffness for more hours a day
- After you take a dose, you wait longer for your medications to work
- The medications’ effects wear off between doses
- You have to take medications more often, including during the night
- You need a higher dose to get the same effect
- Side effects of your medications are becoming a problem for you
Research now shows that deep brain stimulation may be appropriate for people who have had Parkinson’s for at least 4 years, and have at least 4 months of movement symptoms not well controlled by medications, or suffer from medication side-effects such as unintended movements (dyskinesia).
How safe is Deep brain stimulation?
Due to the fact that Deep brain stimulation has now been in use for nearly 30 years, possible complications are well known and can be predicted. Deep brain stimulation is a relatively safe surgical procedure involving minimal risk (such as a seizure or trauma to the brain tissue), while skin infections affect 2.5% of patients yearly.
Should complications occur, they are generally mild, short-lived and normally resolve around 30-90 days after surgery.
As a point of comparison, the risk of death is similar as the risk associated with hip replacement surgery.
DBS Therapy is not for everyone; so it’s important to talk to your doctor about the benefits and risks.
Following are some percentage risks associated with DBS based on a number of studies over last few years:
- 0.6% Temporary surgical complications
- 2.5% Skin infections
- 1.0% Permanent health impairments
- 0.4% Risk of death
The procedure
A neurosurgeon will implant the Deep brain stimulation system in two steps. First, he or she will place the thin wires (leads) that will carry electrical signals to precise areas of your brain. Second, the surgeon will place the small pacemaker-like device, or neurostimulator, under the skin of your chest.
You will have an MRI or CT scan to provide your surgeon with images and maps of your brain. Your doctor may attach a frame, or halo, to your head to help hold it steady during the scan.
Your doctor will use these images to calculate 3-dimensional coordinates of brain locations for lead placement.
Most people undergoing Deep brain stimulation surgery spend a couple of days at the hospital. Healing can take several weeks. You will have pain medications for any discomfort you may have at the incision sites.
While healing, avoid strenuous activities and heavy lifting. Don’t raise your arms above your shoulders, and don’t bend or stretch your neck excessively. As always, follow your doctor’s instructions.
Your doctor will help you decide when you’re ready to return to activities and will turn your device on at your first programming session.
Conclusion
Deep brain stimulation Therapy is often one of the most preferred surgical treatments chosen by many Parkinson’s patients. It is very important to carefully evaluate all options along with your neurologist & neurosurgeon
