August 7, 2019

Making progress: Treating movement disorders with deep brain stimulation

by
Daughter taking care of mother with Parkinson's disease.

Though not a cure, Deep Brain Stimulation (DBS) procedure offers an innovative approach to managing Parkinson’s.

Treating Parkinson’s disease is challenging. The benefits of using medication for it often wear off before the next dose is due. Even despite taking a prescription, bothersome involuntary movements may still occur.

An innovative treatment called deep brain stimulation (DBS) is offering patients hope that their tremors might be treatable. Currently approved for moderate disease, DBS uses electrodes implanted in the brain to transmit electrical impulses from a battery placed under the skin below the collar bone. For people who have Parkinson’s, these electrical impulses may improve stiffness, tremor, or slowed movement.

We asked Fenna Phibbs, M.D., of Vanderbilt Neurosciences to explain more about deep brain stimulation and how it can improve the quality of life for people who have Parkinson’s or certain other conditions. “DBS is not a last resort or a way to turn the clock back on their disease,” Phibbs explained, “but rather a way to get better control of their motor symptoms.”

When should someone consider DBS for Parkinson’s?

DBS won’t change the course of Parkinson’s disease. But patients unsatisfied with symptom control through medication or those looking for more symptom predictability may want to consider DBS procedure. Neurologists recommend the procedure sooner rather than later.

“If this is done earlier in the course of their disease,” Phibbs said, “a patient might benefit for a longer period.” In addition, patients may wish to go forward with a DBS procedure before the development of additional symptoms. “In general,” Phibbs added, “the earlier this is done, the healthier the patients are, which helps better recover from the procedure.”

What are the risks of DBS?

Common side-effects are fatigue, mild confusion and minor pain, Phibbs said. Although any surgical procedure presents risks of bleeding, infection or stroke, the risks of serious complications in a DBS procedure are low. Patients who decide on DBS as their next treatment option often say their quality of life is not where they want it to be, Phibbs explained. “They are willing to accept the risks of the surgery for more predictable symptom control.”

What can a patient expect after the DBS procedure?

After the implanting the device, the neurologist programs the device and adjusts the patient’s medication. This is a long process, often over six to nine months, until symptoms are under good control,” Phibbs said. The process tailors to the individual rather than being one-size-fits-all. Visits with the neurologist typically occur every two to four months. “The battery will need changing,” Phibbs said. “Currently those on the market are lasting three to five years. This depends on how much energy it takes to control symptoms.”

What other conditions can DBS benefit?

DBS is also approved for the treatment of essential tremor, dystonia, obsessive compulsive disorder and certain types of epilepsy. More research continues to conduct how DBS might improve symptoms of depression, Alzheimer’s and Tourette syndrome. “If we know that a brain region is affected by a disease,” Phibbs said, “there is potential that electrical modulation may improve the condition.”

Vanderbilt Neurosciences offers a wide range of specialty programs to treat your brain, spine or central nervous system disorders. Whether you need routine care or a complex surgery, you will benefit from the expertise of many different specialists focused on providing you the best care available.

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