Dear Oakley,
In a recent newsletter, Mr. Farr wrote about Deep Brain Stimulation for Alzheimer’s. He mentioned how it’s been used for Parkinson’s patients for years. My mother has Parkinson’s and this might be something we would consider. Can you provide more information on Deep Brain Stimulation for Parkinson’s?
Thanks!
Dee Bee-Ess
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Dear Dee,
Deep brain stimulation (DBS) has been used for more than 20 years to treat Parkinson’s disease. According to the Parkinson’s Foundation, DBS was first approved in 1997 for more serious cases of Parkinson’s disease, and more recently, in 2016, DBS was approved for the earlier stages of Parkinson’s disease — typically for those who have had Parkinson’s disease for at least four years and have motor symptoms not adequately controlled with medication.
DBS requires a surgical procedure that involves the placement of electrodes deep within the brain that deliver stimulation to block the electrical signals that cause Parkinson’s-related movement disorders. A battery-operated device is implanted under the skin that is similar to a heart pacemaker, but smaller.
Besides Parkinson’s disease, DBS is used to treat essential tremor, dystonia, and psychiatric conditions, such as obsessive-compulsive disorder. It’s also approved for use by the Food and Drug Administration to reduce seizures in difficult-to-treat epilepsy. And per the recent article, it is now being used more widely to treat Alzheimer’s and other forms of dementia.
How Does DBS Work for Parkinson’s Patients?
For the brain surgery portion, neuroimaging (brain MRI or CT) is used to map the brain and identify the area in the brain where the electrodes are to be placed. The electrodes are typically placed while the patient is awake (under local anesthesia) and alert. This is to be sure the effects of stimulation can be tested fully.
The surgeon implants a thin wire lead with a number of electrodes at the tips into a specific area of the brain. In some cases, one lead is implanted into each side of the brain (for a total of two leads). A wire runs under the skin to a pulse generator (neurostimulator) implanted near the collarbone.
During the second portion of the surgery, the surgeon implants the part of the device that contains the batteries (pulse generator) under the skin in the chest, near the collarbone. Wires from the brain electrodes are placed under the skin and guided down to the battery-operated pulse generator.
The generator is programmed to send continuous electrical pulses to the brain. The patient controls the generator, and he or she can turn it on or off using a special remote control.
A few weeks after the surgery, the pulse generator in the chest is activated. The doctor programs the pulse generator from outside the body. The amount of stimulation is customized to the patient’s condition, and it may take as long as four-to-six months to find the optimal setting.
Stimulation may be constant, 24 hours a day, or the doctor may advise the patient to turn the pulse generator off at night and back on in the morning, depending on his or her condition.
Once DBS is working, the electrodes produce electrical impulses that regulate abnormal impulses. The electrical impulses can also affect certain cells and chemicals within the brain. DBS has been proven to help Parkinson’s patients with symptom control and it improves quality of life.
Deep Brain Stimulation Doesn’t Work for Everyone
Keep in mind that DBS doesn’t cure Parkinson’s, as there is no cure at this time, but it may help lessen the symptoms. In some cases, medications are still needed for certain conditions.
Also be aware that DBS isn’t successful for everyone. There are a number of variables involved in the success of DBS. It’s important for your mother to talk with her doctor to determine if DBS is a good option for her and to find out what type of improvement can be expected for her condition.
Hope this helps!
Oakley
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