Here are some common questions patients have about Deep Brain Stimulation (DBS) for Parkinson’s disease, with straightforward answers to help you understand this treatment option.
What is Deep Brain Stimulation?
Deep Brain Stimulation is a surgical procedure used to treat some of the symptoms of Parkinson’s disease. It involves implanting thin wires, called electrodes, into specific areas of the brain. These electrodes are connected to a small, pacemaker-like device called a neurostimulator, which is placed under the skin in the chest. The neurostimulator sends electrical impulses to the brain to help regulate abnormal signals that cause motor symptoms.
Who is a good candidate for DBS?
DBS is typically considered for individuals who have had Parkinson’s disease for at least four to five years and experience significant motor fluctuations, despite medication. This means they have periods when their medication works well (“on” time) and periods when it wears off and symptoms return (“off” time). It’s also an option for those who have troublesome dyskinesia (involuntary movements) as a side effect of their medication. A thorough evaluation by a team of specialists, including a neurologist and a neurosurgeon, is necessary to determine if DBS is the right choice for you.
What symptoms does DBS help with?
DBS is most effective in treating the motor symptoms of Parkinson’s disease that also improve with levodopa medication. These include:
- Tremor: Shaking, especially at rest.
- Rigidity: Stiffness in the limbs or trunk.
- Bradykinesia: Slowness of movement.
- Dyskinesia: Involuntary, erratic movements.
It’s important to note that DBS does not typically improve symptoms that do not respond to levodopa, such as problems with balance, speech, or cognition.
Is DBS a cure for Parkinson’s disease?
No, DBS is not a cure for Parkinson’s disease. It is a treatment that can significantly improve motor symptoms and quality of life. The underlying disease will continue to progress, and adjustments to the DBS settings and medications will likely be needed over time.
What are the risks associated with DBS surgery?
As with any brain surgery, there are potential risks, although they are relatively low. These can include:
- Bleeding in the brain (stroke)
- Infection
- Seizure
- Headache and confusion
- Problems with the device, such as the leads moving or breaking.
Your surgical team will discuss these risks with you in detail before the procedure.
What is the surgery and recovery like?
The surgery is typically done in two parts. The first part involves placing the electrodes in the brain. For this, you may be awake to help the surgeons pinpoint the best location. The second part, usually done under general anesthesia, involves implanting the neurostimulator in the chest and connecting the wires.
Recovery from the surgery itself usually takes a few weeks. You’ll need to avoid strenuous activity during this time. The DBS system is typically turned on and programmed a few weeks after the surgery. It can take several months of adjustments to find the optimal settings for your symptoms.
Will I still need to take Parkinson’s medication after DBS?
Most people will still need to take some Parkinson’s medication after DBS, but often at a lower dose. This can help to reduce the side effects of the medication. The goal of DBS is to provide more consistent control of your symptoms throughout the day.
What is life like with a DBS device?
After the initial recovery and programming period, most people can return to their normal daily activities. You will have a small handheld controller that allows you to turn the device on or off and check the battery. You will need to have regular follow-up appointments to monitor the device and adjust the settings as needed. The battery in the neurostimulator will also need to be replaced every few years, which is a minor surgical procedure.
