Wednesday May 14, 2008
About DBS
What is deep brain stimulation?
Deep brain stimulation (DBS) is a surgical treatment option for patients with Parkinson's disease (PD), tremor and dystonia. DBS has been FDA approved for Essential Tremor and Parkinson's tremor in 1997, advanced Parkinson's disease in 2002 and dystonia in 2003.
What does the surgical procedure involve?
The surgical procedure involves the placement of tiny wires into regions of the brain that are affected in PD. The wires emit continuous electrical impulses (referred to as stimulation) from a device similar to a heart pacemaker, collectively called a neurostimulator. These impulses or stimulation can have a positive affect on the brain activity that is involved in controlling movement and can improve tremor, stiffness, slowness, dyskinesia and some types of walking problems. It is very important that patients understand how the stimulation will affect their symptoms before considering DBS surgery.
What can I expect from deep brain stimulation?
Deep brain stimulation has been shown to be an effective treatment for PD symptoms. As a general rule in PD, a properly placed neurostimulator will mimic the patient's best medication "ON" state. This is the state that results from an optimal medication regimen. The most remarkable benefit of stimulation is an increase in On time without involuntary movements and a decrease in Off time as well as the severity and duration of the Off periods.
What is actually implanted during surgery?
The implanted hardware consists of a thin wire that connects to a neurostimulator battery. The neurostimulator battery is implanted just beneath the skin typically in the chest under the collar bone or in the abdomen which connects to the wire that is implanted into the brain. The neurostimulator battery generates the electrical impulses that travel through the wires to a specific area of the brain. The neurostimulator battery must be replaced periodically when the battery expires, typically every 2-5 years, depending on electrical settings.
What happens after surgery?
After the neurostimulator and battery (brain pacemaker) is implanted, the neurostimulator system must be set properly by a trained programming specialist. The goal of programming is to determine the proper settings that maximize control of symptoms while avoiding potential side effects. One of the many benefits of the neurostimulator is that it is programmable to accommodate each individual's brain anatomy. The neurostimulator system is programmed using an external device that communicates with the neurostimulator battery via radio signals called telemetry which if very similar to the heart pacemaker. Several programming sessions are needed to optimize therapy for each patient and may take up to six months to finalize the programming settings. Over time, as the disease progresses, the stimulation continues to control tremor, stiffness and slowness.
What are some of the advantages of deep brain stimulation?
Deep brain stimulation (DBS) is a surgical treatment option for patients with Parkinson's disease (PD), tremor and dystonia. DBS has been FDA approved for Essential Tremor and Parkinson's tremor in 1997, advanced Parkinson's disease in 2002 and dystonia in 2003.
What does the surgical procedure involve?
The surgical procedure involves the placement of tiny wires into regions of the brain that are affected in PD. The wires emit continuous electrical impulses (referred to as stimulation) from a device similar to a heart pacemaker, collectively called a neurostimulator. These impulses or stimulation can have a positive affect on the brain activity that is involved in controlling movement and can improve tremor, stiffness, slowness, dyskinesia and some types of walking problems. It is very important that patients understand how the stimulation will affect their symptoms before considering DBS surgery.
What can I expect from deep brain stimulation?
Deep brain stimulation has been shown to be an effective treatment for PD symptoms. As a general rule in PD, a properly placed neurostimulator will mimic the patient's best medication "ON" state. This is the state that results from an optimal medication regimen. The most remarkable benefit of stimulation is an increase in On time without involuntary movements and a decrease in Off time as well as the severity and duration of the Off periods.
What is actually implanted during surgery?
The implanted hardware consists of a thin wire that connects to a neurostimulator battery. The neurostimulator battery is implanted just beneath the skin typically in the chest under the collar bone or in the abdomen which connects to the wire that is implanted into the brain. The neurostimulator battery generates the electrical impulses that travel through the wires to a specific area of the brain. The neurostimulator battery must be replaced periodically when the battery expires, typically every 2-5 years, depending on electrical settings.
What happens after surgery?
After the neurostimulator and battery (brain pacemaker) is implanted, the neurostimulator system must be set properly by a trained programming specialist. The goal of programming is to determine the proper settings that maximize control of symptoms while avoiding potential side effects. One of the many benefits of the neurostimulator is that it is programmable to accommodate each individual's brain anatomy. The neurostimulator system is programmed using an external device that communicates with the neurostimulator battery via radio signals called telemetry which if very similar to the heart pacemaker. Several programming sessions are needed to optimize therapy for each patient and may take up to six months to finalize the programming settings. Over time, as the disease progresses, the stimulation continues to control tremor, stiffness and slowness.
What are some of the advantages of deep brain stimulation?
- Surgery can be performed on both sides of the brain for control of symptoms affecting both sides of the body.
- The effects are reversible as the implant can be removed or turned off.
- Surgery and/or stimulation do not destroy or prevent future treatment options such as stem cell or gene therapy when available.
- The device provides continuous symptom control around the clock.
- The stimulation settings are adjustable if needed.