Q: Who could benefit from Deep Brain Stimulation (DBS)?
A: Previously, only people with more severe Parkinson’s were offered DBS. However, DBS is now being used in people who have had Parkinson’s for more than four years and have just started to experience fluctuations in the control of their symptoms despite taking medication.
It is hoped that DBS will better control symptoms in these patients, enabling them to maintain friendships, social interaction, employment and activity, giving them better quality of life. DBS is also used to treat other diseases causing tremor, muscle spasms and contractions. It is being evaluated as a treatment for some forms of epilepsy and Tourette’s.
Q: What happens in the procedure?
A: Surgeons drill a small hole in the skull and carefully place specially-made wires (leads) into specific parts of the brain using a special guidance frame or robot. The leads are connected to an electrical pulse generator (similar to a pacemaker) placed under the skin over the chest.
The procedure, which can last as little as three hours, is often done with the patient awake. This allows the neurologist to check that the wires are correctly placed to control symptoms without stimulating unintended parts of the brain. The ‘dose’ of electrical stimulation is programmed by a specialist to suppress symptoms of the disease.
Q: What are the risks?
A: DBS should only be carried out by experienced teams, after careful evaluation of the risks and potential benefits. Potential risks, though rare, include bleeding in the brain, infection, and the risk that the leads delivering the therapy are not optimally placed (leading to sideeffects with stimulation).