Indications Section

Since 1987[i], when Deep brain stimulation (DBS) was introduced as a treatment for essential tremor symptoms, it has proven to be a landmark discovery. This is especially true in deep brain stimulation of the subthalamic nucleus or globus pallidus inturnus in Parkinson’s disease (PD), where it is currently the standard surgical procedure[ii]. DBS has been shown to be extremely effective in improving PD’s symptoms, and allowing for a decrease in medication[iii].

DBS involves placing electrodes inside certain areas of the brain. These electrodes create electrical impulses that control abnormal impulses. The electrical impulses can have an effect on certain cells and chemicals in the brain.

In recent years, deep brain stimulation has emerged as an innovative treatment option for a number of neurological and psychiatric diseases. The following conditions have been approved by the United States Food and Drug Administration (FDA)[iv]:

  • Essential tremor (1997)
  • Parkinson’s Disease (2002)
  • Dystonia (Humanitarian device exemption-2003)
  • Obsessive-Compulsive Disorder (2009)
  • Epilepsy

DBS is also showing success in investigational clinical studies for many other conditions, including traumatic brain injury (TBI), addiction, dementia, stroke recovery, tourette syndrome, cluster headache, among others. [v]

Learn More About Possible Benefits & Risks

Primary Risks

Deep brain stimulation is considered a safe and effective procedure. According to research, 3.4 percent of patient undergoing DBS experienced bleeding in the brain during the procedure, while 1.2 percent experienced paralysis on one side of the body, within hours of the procedure.[i] Yet, it is important to remember that like with any surgical procedure, there is always a risk of complications. Additionally, the actual stimulation on the brain itself, can also result in some side effects.

Some risks seen with DBS include[ii]:

  • Bleeding in the brain (3.4%)
  • Seizure (0.3%)
  • Stroke (1.7%)
  • Heart problems (0.1%)
  • Infection (1.4%)

Some side effects seen with the brain stimulation on the brain itself:

  • Issues with balance (0.1%)
  • Double vision and Numbness (1.0%)

THERAPEUTIC OPTIONS OVERVIEW

You might consider these options independently or together.

Sleep or Awake DBS?

Since the start of DBS, the normal method of DBS involved being awake for 4-6 hours[i]. This method was not readily accepted by patients, who did not want to be awake through the process, which involved the insertion of electrodes in the brain. Recent research conducted in Oregon indicates that sleep DBS, where patients are asleep during surgery, is equally effective.[ii] Furthermore, For patients with PD, results from the research study reports that outcomes for motor function improvement, translating to improvement in tremors, muscle rigidity, and mobility, is similar between sleep and awake DBS.[iii] In addition, results from sleep DBS shows that they may be some superiority in outcome with sleep DBS, when it comes to improvements in some other aspects of quality of life, as well as with speech.[iv]

REQUEST TO SPEAK WITH A PARKINSON’S COMMUNITY ADVOCATE BY PHONE

REFERENCES & RESOURCES

Putting Patients First

[i] M. I. Hariz, P. Blomstedt and L. Zrinzo (2010). Deep brain stimulation between 1947 and 1987: the untold story. Neurosurg Focus, 29(2): E1.

[ii]Hamani, C., Florence, G., Heinsen, H., Plantinga, B. R., Temel, Y., Uludag, K., Alho, E., Teixeira, M. J., Amaro, E., … Fonoff, E. T. (2017). Subthalamic Nucleus Deep Brain Stimulation: Basic Concepts and Novel Perspectives. eNeuro, 4(5), ENEURO.0140-17.2017

[iii] Hamani, C., Florence, G., Heinsen, H., Plantinga, B. R., Temel, Y., Uludag, K., Alho, E., Teixeira, M. J., Amaro, E., … Fonoff, E. T. (2017). Subthalamic Nucleus Deep Brain Stimulation: Basic Concepts and Novel Perspectives. eNeuro, 4(5), ENEURO.0140-17.2017

[iv]  Gardner J. (2013). A history of deep brain stimulation: Technological innovation and the role of clinical assessment tools. Social Studies of Science, 43(5), 707–728.

[v] Gardner J. (2013). A history of deep brain stimulation: Technological innovation and the role of clinical assessment tools. Social Studies of Science, 43(5), 707–728.

[i] Fenoy, Albert & K Simpson, Richard. (2013). Risks of common complications in deep brain stimulation surgery: Management and avoidance. Journal of neurosurgery. 120. 10.3171/2013.10.JNS131225.

[ii] Fenoy, Albert & K Simpson, Richard. (2013). Risks of common complications in deep brain stimulation surgery: Management and avoidance. Journal of neurosurgery. 120. 10.3171/2013.10.JNS131225.

[i] Watson, J. (2018, February 5). Rest Easy: Asleep Deep Brain Stimulation as Effective as Awake. Retrieved February 10, 2019, from https://www.medscape.com/viewarticle/891935

[ii] Watson, J. (2018, February 5). Rest Easy: Asleep Deep Brain Stimulation as Effective as Awake. Retrieved February 10, 2019, from https://www.medscape.com/viewarticle/891935

[iii] Watson, J. (2018, February 5). Rest Easy: Asleep Deep Brain Stimulation as Effective as Awake. Retrieved February 10, 2019, from https://www.medscape.com/viewarticle/891935

[iv] Watson, J. (2018, February 5). Rest Easy: Asleep Deep Brain Stimulation as Effective as Awake. Retrieved February 10, 2019, from https://www.medscape.com/viewarticle/891935