Deep Brain Stimulation is a modern surgical treatment modality used for the treatment of patients with Parkinson’s disease (PD).
It is also used for certain other movement disorders like ‘Dystonia’ and ‘Essential Tremor’
DBS can relieve the motor (movement- related) symptoms of the disease- like stiffness of limbs, tremor and slowness- to a significant degree.
Research done all over the world including our center indicate that the overall improvement in these symptoms vary from 50-70% approximately.
DBS provides a stable baseline control of symptoms (Which is around 50 % or so of the symptom control obtained in the best “on” period with oral medications.
However unlike the symptom control provided by medications, which fluctuates related to the administration of each dose, the benefits provided by DBS tend to remain stable).
This allows reduction in the dose of medicines considerably in most cases, thus reducing the ‘drug induced dyskinesia’ (abnormal “dance-like” movements occurring during the beneficial period (“on”) of medicines).
Thus, DBS, along with the modified dose of medications, provides a more predictable and sustained relief of symptoms than that provided by medical treatment alone before surgery, by reducing the ‘fluctuations’ or ups and downs of medical treatment.
Even though reduction in the dose of medications is possible in the majority, only a small percentage of patients can be totally free of medications after surgery.
The aim of DBS is not to withdraw medications completely, but to improve the quality of life by reducing the “motor fluctuations” (reducing the ‘off’ time parkinsonian symptoms and duration of “off” time) and ‘on’ time dyskinesias.
In a well-chosen case with properly supervised concurrent medical therapy, most patients do well and are able to carry out most of their daily activities independently. It may be possible for some patients to return to work.
Will all movement related problems improve with DBS?
• The symptoms like stiffness of limbs, tremor and slowness of activities are likely to have a very good response to DBS.
• Certain disturbances in walking (like imbalance/ falls/ “Freezing of gait” etc) may not have a similar excellent response.
• The reason is that these sort of problems could also occur due to neuro-degeneration (nerve cell death) happening in areas in the “brain-stem” outside those targeted by DBS, in Parkinson’s disease.
• Freezing of gait and other walking disturbances, which responds initially to DBS, may re-appear later because of the gradual progression of Parkinson’s disease and involvement of these areas in the brainstem crucial to walking function.
• Generally, patients with Parkinson’s disease in whom the Freezing improves in “on” period with drugs, are likely to have improvement of Freezing with DBS also, at least temporarily. Disturbances of speech and swallowing function will not improve with DBS.
Disclaimer: The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. The information is provided solely for educational purpose and should not be considered a substitute for medical advice.
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