Deep Brain Stimulation Treatment
Deep brain stimulation (DBS) is used to treat debilitating symptoms of Parkinson's disease, such as tremors, slow movement and walking problems. During DBS, a surgically implanted, battery-operated device called a neurostimulator delivers electrical stimulation to areas of the brain that control movement and blocks the nerve signals that cause tremors and other symptoms of Parkinson's disease.
The DBS system consists a thin wire (lead) that is inserted through a small opening in the skull and implanted in the patient's brain at the targeted area. Patients are awake but lightly sedated during the procedure, as the surgeon tests areas of the brain while patients move their arms, legs or fingers to help find the best position for the lead.
The battery pack (neurostimulator) is implanted under the skin near the collarbone or lower in the chest while the patient is sedated. Both the neurostimulator and the leads are connected by a thin wire (extension) that is passed under the skin of the head, neck and shoulder. Electronic impulses are sent from the neurostimulator along the extension and lead, and into the brain.
If a patient's condition changes, the stimulation is adjustable without additional surgery. Parkinson's disease symptoms can decrease with DBS, often allowing patients to reduce their use of medications for treatment. In some cases, side effects from dyskinesias (involuntary movements caused by long-term use of levodopa) can decrease or even be suppressed through DBS.
Healing will take several weeks and can be managed with medication. Physicians can program the device to best control symptoms while minimizing side effects. Best results will usually be seen after the system has been fine-tuned for the patient.
Symptoms of Parkinson's disease get worse over time. DBS must be done before the body stops responding to medication or it will not be an option. There are signs to watch for when medication is becoming less effective:
- More hours a day with symptoms
- Longer wait before relief begins after taking a dosage
- Medication wearing off between doses
- Increase of needed intake, including at night
- Drug-induced side effects such as uncontrolled movements
Most people don't feel the stimulation as it reduces their symptoms except for a brief tingling when the stimulation is turned on. As Parkinson's disease symptoms change over time, physicians are often able to adjust the DBS system settings.
Most patients receive an average of five more hours of symptom-free time every day, in addition to what they receive from medications, when using the DBS therapy along with their medication. DBS does not add to your medication and most patients see a decrease in the amount of medication, leading to less drug-induced side effects.