Deep brain stimulation (DBS) is an established surgical treatment for the symptoms of Parkinson’s Disease or Essential Tremor. The NeuroHealth Parkinson’s Disease and Movement Disorders Center is the only facility in Rhode Island that can provide this cutting-edge treatment for their patients.
The procedure involves surgically implanting a battery-operated medical device called a neurostimulator to deliver continuous, high-frequency electrical stimulation to targeted areas of the brain. Depending on the disease being treated, different parts of the brain may be stimulated.
In patients with Parkinson’s Disease, the electrode is placed in a structure called the subthalamic nucleus. Stimulation of this structure often results in marked improvement in stiffness, slowness, tremors, and other disabling symptoms. Although most patients still need to take medication after undergoing deep brain stimulation, many patients experience a considerable reduction in symptoms and are able to reduce their medications greatly.
In patients with essential tremor, the thalamus is the area of the brain that is stimulated. The goal of DBS in essential tremor is to completely suppress the tremor. While this goal in not able to be achieved in all patients, the tremor can be reduced in most patients, and the majority of patients are able to resume performing basic daily acts of living without disability or embarrassment.
DBS is a wonderful treatment for many patients with movement disorders. It is reversible, adjustable, and less risky than pallidotomy and thalamotomy.
Is DBS right for me?
The ideal candidate for DBS surgery is a younger patient (younger than 75 years) without dementia or other serious medical problems. The surgical candidate must be significantly impaired by Parkinson’s disease or essential tremor, despite optimal medical therapy. Ideally, he or she should also have a good “support system” and be able to come to the Parkinson’s Disease and Movement Disorders Center for adjustments.
However, we realize that each patient is unique, and we evaluate each surgical candidate on a case by case basis. To schedule a DBS evaluation, please call us at 401-732-3332.
The DBS evaluation
During the evaluation, you will meet with one of our movement disorders specialists. The specialist review your history and the various treatments that have been tried. He/She will also perform a thorough neurological examination. You will be provided with more information about DBS, if he feels you may be a good surgical candidate. Alternatively, he may try to optimize your medications first before sending you through the rest of the DBS screening process.
Once you are determined to be a good candidate, you will undergo neuropsychological and psychiatric evaluations. If you have Parkinson’s disease, you will also return for a formal examination while on and off medications.
If you meet all the criteria, you will be referred for neurosurgical evaluation. This is where the neurosurgeon explains the surgery to you in detail and schedules you for the operation.
Approximately two weeks after surgery, one of our specialists will turn on the stimulator and try several different settings before deciding on the best setting. Follow-up visits will be scheduled at the Parkinson’s Disease and Movement Disorders Center as needed for adjustments. These may be more frequent at first as your stimulator is fine-tuned, but usually occur once every few months after the stimulator settings are stable.