Dr. Paul S. Fishman, MD, works with a movement disorders patient receiving deep brain stimulation treatment.
Deep brain stimulation (DBS) is a procedure used to treat symptoms of Parkinson's disease, essential tremor, dystonia and related conditions.
What Is Deep Brain Stimulation?
DBS involves using electrical stimulation to control abnormal brain signals linked to symptoms of movement disorders. This technique requires surgeons to implant electrodes into the brain through a tiny opening in the skull. These electrodes connect to a battery-operated generator typically positioned under the collarbone, with wires running beneath the skin.
The generator emits electrical impulses to the electrodes, targeting and disrupting the problematic brain signals that lead to tremors and other related symptoms. This process helps manage and alleviate the symptoms associated with movement disorders.
Choose UMMC for Deep Brain Stimulation
At UMMC, we personalize your therapy with the help of a dedicated DBS team. This team includes highly experienced experts from both our neurology and neurosurgery departments.
Every candidate undergoes a thorough examination, which includes comprehensive psychiatric and neuropsychological evaluations. To tailor surgical and medical therapies to your specific needs, all patients are reviewed by a multidisciplinary panel that includes a diverse group of specialists. This collaborative approach ensures that your care is both personalized and comprehensive.
Our multidisciplinary team closely monitors patients at every stage of the DBS process, ensuring thorough follow-up care. This includes frequent and detailed check-ins in the weeks, months, and years following the surgery to support your ongoing recovery and adjust treatment as needed.
Here's a breakdown of the Parkinson's disease symptoms that DBS can help with:
Symptoms DBS helps with:
Tremor: DBS can significantly reduce the involuntary shaking that is characteristic of Parkinson's.
Rigidity: Stiffness in the limbs and torso can be lessened through DBS.
Bradykinesia: This is the slowness of movement that patients experience, and DBS can help improve this symptom.
Dyskinesia: Involuntary, erratic, writhing movements of the face, arms, legs, or trunk are reduced by DBS, especially those caused by long-term use of the drug levodopa.
Motor fluctuations: DBS can stabilize variations in motor performance due to the wearing off of medications.
Symptoms DBS does not typically help with:
Non-motor symptoms: These include cognitive decline, mood disorders (like depression and anxiety) and sleep disturbances.
Balance problems: Issues with balance and falls are generally not improved by DBS.
Freezing of gait: While some improvement might be seen, DBS is not consistently effective in treating freezing of gait, where a patient temporarily feels as if their feet are glued to the floor.
Speech problems: Some patients may experience worsening of speech issues after DBS treatment.
Dementia: DBS does not improve cognitive decline or dementia associated with Parkinson's disease.
DBS can help with some essential tremor symptoms and not others. Here's a breakdown:
Symptoms DBS helps with:
Tremor: DBS is primarily used to reduce tremors, particularly in the hands, which are the most common manifestation of essential tremor. It can significantly improve the ability to perform daily activities such as eating, drinking and writing.
Voice tremors: In some cases, DBS can help reduce tremors that affect the voice, making speech clearer and more stable.
Head tremors: DBS can also be effective in reducing tremors that involve the head, though the results can vary.
Symptoms DBS does not typically help with:
Non-motor symptoms: Essential tremor can be associated with non-motor symptoms such as anxiety and cognitive changes, which DBS does not typically address.
Underlying causes: DBS treats the symptoms of essential tremor but does not cure the underlying neurological changes that cause the condition.
Balance issues: If a person with essential tremor has balance problems, DBS is unlikely to provide relief in this area.
Progression of tremor: While DBS can reduce the severity of tremors at the time of treatment, it does not prevent the progression of tremor severity over time.
DBS can be an effective treatment for reducing the severity of symptoms in certain types of dystonia, particularly those that are localized or segmental. As with any medical treatment, outcomes can vary, and it's essential for patients to discuss the potential benefits and limitations with their health care providers.
Here's a breakdown of the symptoms DBS can and can't help with:
Symptoms DBS helps with:
Muscle contractions: DBS can significantly reduce involuntary and sustained muscle contractions that cause twisting and repetitive movements or abnormal postures.
Pain: Many patients experience pain due to the constant muscle contractions. DBS can alleviate this symptom by reducing the frequency and intensity of the contractions.
Functional improvement: By controlling the muscle contractions, DBS can improve mobility and function, helping patients perform daily activities more effectively.
Symptoms DBS does not typically help with:
Non-motor symptoms: Dystonia may be associated with non-motor symptoms such as depression and anxiety, which are generally not improved directly by DBS.
Cognitive issues: If a patient with dystonia experiences cognitive difficulties, DBS does not target these symptoms and is unlikely to offer improvement.
Speech difficulties: In cases where dystonia affects speech muscles, results from DBS can be variable; it may not consistently improve speech and can sometimes cause difficulties.
Underlying disease progression: DBS does not cure dystonia or halt its progression; it primarily manages the symptoms.
Benefits and Risks of DBS
In patients with Parkinson's disease, DBS can effectively manage symptoms such as slowness, stiffness, tremor, and dyskinesia. Often, patients can significantly reduce their medication dosage following DBS.
The DBS device can also be reprogrammed to accommodate changes in symptoms. Battery replacement is the only additional surgery required, typically every 3-5 years or every 10 years, depending on the battery type.
For those with essential tremor, DBS significantly alleviates tremors. In cases of dystonia, it helps manage symptoms associated with involuntary muscle contraction.
However, DBS carries risks as it involves brain surgery. These include a small risk of infection or bleeding. In rare instances, significant bleeding can occur, leading to stroke-like symptoms and temporary confusion.
Make an Appointment
Call us at 410-328-6034 to schedule a consultation with one of our specialists or get more information on DBS at UMMC .
