Deep Brain Stimulation (DBS) is one of the most exciting new treatment options for patients with Parkinson’s disease. In fact, a recent article in STAT highlighted DBS as one of the greatest medical innovations of the past century. With so much buzz around this treatment, you may be wondering what exactly Deep Brain Stimulation is and how it can benefit those living with Parkinson’s Disease. Parkinson’s disease is a chronic neurological condition that affects almost 1 million people in the United States alone. It usually presents itself when proteins called ‘alpha-synuclein’ abnormally accumulate in certain regions of the brain involved in movement and coordination, such as the substantia nigra and locus coeruleus as well as other areas outside of the nervous system.
What is deep brain stimulation?
Deep brain stimulation is a surgical procedure that involves implanting electrodes in select parts of the brain that are affected by Parkinson’s disease. The electrodes then connect to a tiny implanted device called a ‘brain stimulator’ that delivers electrical pulses to the electrodes in order to modulate brain activity. Deep brain stimulation is used as a treatment for a number of medical conditions, but it is primarily used to treat Parkinson’s disease by regulating abnormal brain activity and encouraging the release of dopamine in the substantia nigra (the brain region primarily responsible for movement).
How Deep Brain Stimulation Works?
As mentioned above, deep brain stimulation involves implanting electrodes in select parts of the brain. These electrodes connect to a tiny implanted device called a ‘brain stimulator’ that delivers electrical pulses to the electrodes in order to modulate brain activity. In Parkinson’s disease, the substantia nigra is impaired because of the accumulation of alpha-synuclein. This results in reduced dopamine production and subsequently certain symptoms of Parkinson’s disease such as tremors, stiffness, and difficulty with movement. DBS attempts to increase dopamine levels and restores normal movement by regulating abnormal brain activity. In other words, DBS is able to ‘turn off’ certain parts of the brain that are overactive and ‘turn on’ other parts of the brain that are underactive or inactive.
Treating Parkinson’s’ disease with deep brain stimulation
Successful treatment of Parkinson’s disease with Deep Brain Stimulation depends on a number of factors including age and the severity of symptoms. Furthermore, it is important to note that DBS is not a cure for Parkinson’s disease, but rather a treatment option that can improve both quality of life and long-term outcomes. Parkinson’s disease is a degenerative condition that progresses throughout the duration of illness. This means that symptoms often worsen as the disease progresses. For example, while a mild tremor at the onset of the disease may cause little disruption in everyday activities, a severe tremor at the end of the disease may prevent a person from performing basic self-care activities like dressing and hygiene. Deep brain stimulation can slow the progression of Parkinson’s disease and significantly improve quality of life even for those with a more advanced stage of the disease.
Procedure of Deep Brain Stimulation surgery
Deep brain stimulation surgery is a minimally invasive procedure that is performed under general anesthesia. Typically, this surgery is performed on an outpatient basis with the patient staying in the hospital for a single evening. The surgeon will first place a stereotactic frame (a customized frame that is fitted to the shape and size of a patient’s head) in order to accurately and precisely target the areas of the brain that will receive the electrodes. The frame will stay in place throughout surgery and will have small markings indicating the exact location of the target areas. Next, the surgeon will make a small incision in the head. Using the markings on the stereotactic frame as a guide, the surgeon will place the electrodes within the targeted brain areas with precision.
What are the long term results of DBS?
As with any medical procedure, there are some potential side effects associated with deep brain stimulation. The most common side effects of DBS include infections, electrode dislodgement, and the potential for the electrodes to shift position within the brain. As with any medical procedure, there are some potential side effects associated with deep brain stimulation. DBS is a long-term treatment, with electrodes typically remaining implanted for a period of two to five years. Depending on how the disease progresses, patients may choose to have the electrodes implanted permanently.
FAQ
Will DBS surgery affect my personality?
Yes, there are reports of personality changes following deep brain stimulation. That being said, it is important to mention that these changes are relatively modest compared to the effects of the disease itself.
How much does DBS surgery cost?
Costs vary depending on your location, medical insurance provider, and the type of coverage you have. Overall, it is estimated that DBS surgery costs between $30,000-$50,000.
How do I know if DBS is right for me?
If you are experiencing significant symptoms of Parkinson’s disease and have tried other treatments with minimal improvement, talk to your neurologist about the benefits of DBS.
How long will the surgery last?
DBS surgery lasts between 4-6 hours.
