DBS for Parkinson's

HOW DBS MAY HELP YOU

Deep Brain Stimulation (DBS) is an established surgical procedure for movement disorders such as Parkinson’s.  Working in a similar way to a heart pacemaker, a neurostimulator uses electric pulses to regulate brain activity.  For those who successfully undergo DBS, the effects can be life-changing, and researchers who have followed patients after DBS have found that many patients continue to have improvements in their symptoms for several years after the procedure and are able to eat, use the bathroom and feed themselves.  

DBS is not a cure and does not stop Parkinson’s from progressing, but it can help ease motor symptoms and decrease medication.  In many cases, it has given people with the condition better control of their motor (movement) symptoms including tremor, speed of movements and involuntary movements (dyskinesia).  Successful DBS allows a decrease in medication or makes a medication regimen more tolerable. 

Whilst transformative for some, DBS is not suitable for everyone.  If patients are well managed on medications, DBS, at the moment, is not considered.  DBS may worsen thinking or memory problems, so it’s not recommended for people with dementia.

Before being considered a candidate for DBS, patients with Parkinson’s disease must undergo an extensive evaluation process carried out by a team of specialists including a neurologist, neuropsychologist, and neurosurgeon who will determine if surgery is an option. 

Candidates for DBS usually need to meet one or more of the following criteria:

  • Symptoms are not well controlled despite receiving the appropriate dose of levodopa and other medications.
  • Symptoms are significantly reducing your quality of life.
  • Abnormal or uncontrolled involuntary movements (dyskinesia) or motor fluctuations are not improving despite adjustments in medications.
  • Tremors that have not been able to be controlled by medication
  • Medications have become less effective, and their side effects interfere with a person’s daily activities.

BENEFITS AND RISKS OF DBS

Deep Brain Stimulation is a serious and potentially risky procedure, so it is important to weigh the pros and cons. Even if you may be eligible for DBS, you and your doctors must carefully consider the risks and potential benefits of the procedure.

Deep brain stimulation (DBS) has many advantages:

DBS therapy improves the quality of life by 13% to 26% compared to before receiving DBS. 11 12 Improved quality of life includes things such as feeling better emotionally, feeling less embarrassed in public, moving about more easily, and having less physician discomfort. In the same studies, patients receiving the best medical therapy (BMT) without DBS showed no improvement in quality of life compared with their baseline.

In detail some of the main advantages of DBS could be indicated here:

  • DBS does not cause permanent damage in any part of the brain.
  • The electrical stimulation is adjustable and reversible as the person’s disease changes or his or her response to medications change.
  • Because DBS is reversible and causes no permanent brain damage, the use of innovative not-yet-available treatment options may be possible.
  • The stimulator can also be turned off at any time if DBS is causing excessive side effects without any long-term consequences.
  • Decreased tremor
  • Fewer medications.  Most people are able to decrease (but not completely discontinue)
  • Parkinson’s drugs after DBS. Without DBS, people receiving the best medical therapy (BMT) experience between a 5.4% reduction to a 13% increase in drug-related complications compared with their baseline.

DBS is not a medication and it does not contain medication. In many cases, DBS therapy helps patients reduce the number of their Parkinson’s drugs by up to 50%.

What are the risks and complications of Deep Brain Stimulation (DBS)?

Although Deep Brain Stimulation is generally considered to be low risk, any type of surgery carries the risk of complications. In patients who are properly selected, DBS is safe and effective. Risks and potential side effects do exist, but they are generally mild and reversible.

Complications of DBS fall into three categories: surgery complications, hardware (device and wires) complications, and stimulation-related complications.

Risks may include:

  • 1% risk of brain haemorrhage, including stroke
  • Infection
  • Device malfunction
  • Lack of benefit for certain symptoms
  • Headache
  • Worsening mental or emotional status

During stimulation, side effects may include:

  • Temporary tingling in the face or limbs
  • A feeling of pulling in muscles
  • Speech or vision problems
  • Loss of balance

Possible side effects of stimulation:

(These side effects are reversible when the device is adjusted.)

  • Numbness or tingling sensations
  • Muscle tightness of the face or arm
  • Speech problems
  • Balance problems
  • Light-headedness
  • Vision problems, such as double vision
  • Unwanted mood changes, such as anger and depression..

BENEFITS OF Aleva DBS

Aleva’s DBS system has been designed to improve patient’s outcomes by allowing a more precise stimulation of the correct areas of the brain through innovative technological solutions. 

If you would like to receive more information about this therapy, please contact us and we will direct you to an independent specialised Healthcare Professional who will guide you through the options and will identify the best treatment for your or your loved one’s unique situation.

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Footnotes

12 Okun MS, Foote KD. Parkinson’s disease DBS: what, when, who and why? The time has come to tailor DBS targets. Expert Rev Neurother. 2010 December; 10(12): 1847–1857.

13 Weaver FM, Follett KA, Stern M, et al. Bilateral deep brain stimulation vs. best medical therapy for patients with advanced Parkinson’s disease. JAMA. 2009;301(1):63-73.