Deep Brain Stimulation Surgery
Hoag has a robust Deep Brain Stimulation surgery program. Hoag has two neurosurgeons, The Christopher Duma (program surgical director) and Dr. Alexander Taghva, who perform either awake or asleep DBS.
What is Deep Brain Stimulation?
Deep Brain Stimulation (DBS) is the most common surgical treatment for Parkinson’s disease (PD). In PD, DBS can decrease and control motor symptoms such as tremor, slowness and stiffness. DBS can also lessen medication-related complications, such as involuntary movements (dyskinesias) and can help reduce abnormal, often-painful muscle contractions (dystonia).
DBS can also reduce overall medication needs and help to control irregular symptoms related to medication wearing off. Typically, symp- toms that improve with medications will also improve with DBS. Tremor, however, will often respond to DBS even if it does not respond to medications.
DBS does not slow the disease progression and is not a cure nor an option for everyone. DBS does not usually ease non-motor symptoms of PD such as speech, mood, memory or thinking changes, bladder, bowel or sexual changes. DBS does not generally work for core body symptoms such as visual disturbances, voice changes, gait and balance dysfunction. DBS may worsen cognitive decline and depression in some individuals.
DBS is approved by the FDA for the treatment of PD and essential tremor.
Is DBS an option for me?
DBS is an option if you:
- Have had PD for at least four years
- Have typical Parkinson’s disease with symptoms that respond to Levodopa
- Experience medication-related problems such as dyskinesias
- Do not have significant memory, mood or thinking changes
- Are in general good health able to tolerate a surgical procedure and anesthesia
- Have good social support
Poor candidates for DBS are those who have:
- Atypical Parkinson’s disease that does not respond to Levodopa
- Frequent falls despite medication
- Severe memory loss, confusion, hallucinations and cognitive decline
- Severe depression or anxiety
- Severe medical problems that would pose a surgical risk
- A lack of social support
How does DBS work?
In DBS surgery, electrodes are inserted into specifically targeted areas of the brain that are identified using imaging These electrodes are then attached to an implantable pulse generator (IPG) or battery. The IPG is placed below the collarbone or, less commonly, in the abdo- men and is then attached to the wires which connect to the electrodes. The IPG sends electrical impulses to the brain to override move- ment symptoms that cause problems. This is similar to a pacemaker device that treats heart rhythm disturbances. Most patients require DBS to be placed on both sides of the brain. However, you may only need placement of electrodes on one side of the brain.