Deep Brain Stimulation for Parkinson's Disease
Is Deep Brain Stimulation Experimental?
No. Deep brain stimulation is not experimental. DBS of the thalamus was approved by the FDA for the treatment of Parkinson's disease and essential tremor in 1997. But, since stimulation of the thalamus is only effective for treating tremor and rigidity symptoms, it is not recommended for the treatment of Parkinson's disease. This is because even if a person currently only has tremor or rigidity, he or she will eventually develop other symptoms that would only be helped by stimulation of the subthalamic nucleus or globus pallidus. Therefore, stimulation of the subthalamic nucleus or globus pallidus is recommended.
Who Should Consider Deep Brain Stimulation?
There are many important issues to be addressed when considering deep brain stimulation. These issues should be discussed with a movement disorders expert or a specially trained neurologist. A movement disorders expert is someone who has trained specifically in movement disorders.
One of the most important criteria is that the person has had an adequate trial of medications. Surgery is not recommended if medications can adequately control the disease. However, surgery should be considered for people who do not achieve satisfactory control with drugs. Talk to your doctor to see if DBS is right for you.
Is Age a Factor in Deep Brain Stimulation?
Deep brain stimulation has been successful in treating people of different ages. However, each person should be assessed individually as to their stamina and overall health before considering surgery.
Where Should Deep Brain Stimulation Be Performed?
The first and most important recommendation is that the deep brain stimulation procedure be performed in a place where there is a multi-disciplinary team of experts. This means neurologists, neurosurgeons, and neurophysiologists who have experience and specialized training in performing these types of surgeries.
The next important consideration is how the surgery is done. Different centers may perform the procedure in different ways. It is very important to ask how the target (the thalamus or globus pallidus) is targeted. It is clear that the chances of benefit and the risks of complications are directly related to how close the electrode is to the correct target.
Will I Be Asleep During the Deep Brain Stimulation Procedure?
You will remain awake during most of the deep brain stimulation procedure. This allows the surgical team to interact with you when testing the effects of the stimulation. Small amounts of local anesthetic (pain-relieving medication) are given in sensitive areas. The vast majority of people experience minimal discomfort during the procedure.
What Should I Expect After Deep Brain Stimulation?
You may feel tired and sore but will be given medication and kept comfortable after your deep brain stimulation procedure. Also, you may have irritation or soreness around the stitches and pin sites.
As with any surgery, there are some guidelines and limitations that you should follow after DBS. Be sure to discuss these with your doctor and ask questions before surgery. Understanding what you will be experiencing and knowing what to expect afterward can help ease some of the natural anxiety that comes with any medical procedure.