Deep Brain Stimulation for Parkinson's Disease

Deep Brain Stimulation for Parkinson's Disease

Benny Burton's tremors from Parkinson's disease made holding a job impossible and greatly interfered with his social life. Their life was very difficult. "I couldn't go out to eat, couldn't take my wife to dinner because people would stare. Eating was the worst part, picking up that spoon, driving food all over, and drinking, driving and glasses."

But after the surgical procedure known as deep brain stimulation (DBS), Benny got his old life back. He calls it a miracle. "I went from this to this immediately." Something as simple as pouring a drink is no longer a problem, and those results are common.

Deep brain stimulation is a remarkably effective therapy for symptoms of movement disorders. It can dramatically improve the quality of life in patients with Parkinson's disease, essential tremor, and dystonia, and it has long-lasting effects. The surgery involves putting an electrode in the brain to modulate brain activity to reduce symptoms for Parkinson's disease - particularly for those patients who no longer respond to medication. The symptoms we try to reduce are those of tremor, rigidity, cramping, dystonia, and dyskinesia.

Here's how the surgery works: First, a frame is placed over the head to stabilize it. Next, an MRI pinpoints the brain region where electrical nerve signals in the brain are misfiring. An electrode attached to a wire is inserted through a tiny opening in the skull and implanted in the trouble spot in the brain.

After placing the electrode, we keep an enormous database of the impact that these electrodes have on patient outcomes. The location of the electrode and its impact on outcomes are meticulously recorded. Over the years, we've been able to determine the best location to provide the best outcome for targeted symptoms. I believe in the country, we're the best institution for understanding what signs and symptoms in the operating room predict good outcomes.

The brain electrode is connected to a wire leading to a neurostimulator placed under the skin just below the collarbone. The stimulator works like a pacemaker, modulating brain activity to suppress the tremor. The patient remains awake during the surgery; it's crucial to keep the patient awake so we can see the effects of our stimulation. The neurostimulator can be adjusted with a radio signal, and remarkably, patients go home the next day after surgery.

One of the misconceptions people have is that it's experimental. It's not. It's a well-documented procedure with low risk. It's a safe procedure that has been performed in more than 70,000 people worldwide. We have one of the largest movement disorder centers, not only in the United States but in the world. We have 12 movement disorders neurologists who all specialize in various aspects of movement disorders. Here at UAB Hospital, 80 to 100 DBS surgeries are performed every year.

Dr. Harrison Walker demonstrates how, when the stimulator is turned off, the tremors return and back on again, Benny's tremors are gone. Benny says he felt no pain during the surgery and is thrilled with the care he received at UAB. "From the very beginning to the pre-op to the actual operation step, I felt loved, cared about, and concerned that everything was going to be all right, better than it was."

Benny Burton credits the expert and compassionate care he received at UAB Hospital for giving him this new lease on life.

Keywords

• Deep Brain Stimulation (DBS)
• Parkinson's Disease
• Movement Disorders
• Tremors
• Neurostimulator
• UAB Hospital
• Surgical Procedure
• Electrodes
• MRI
• Patient Outcome
• Dr. Harrison Walker

FAQ

Q: What is Deep Brain Stimulation (DBS)?
A: DBS is a surgical procedure that involves implanting electrodes in the brain to modulate brain activity and reduce symptoms associated with movement disorders such as Parkinson's disease, essential tremor, and dystonia.

Q: How does DBS help Parkinson's disease patients?
A: DBS helps by reducing symptoms like tremor, rigidity, cramping, dystonia, and dyskinesia, especially in patients who no longer respond to medication.

Q: Is DBS an experimental procedure?
A: No, DBS is a well-documented procedure with a low risk. It has been performed in more than 70,000 people worldwide.

Q: Do patients need to stay in the hospital for a long time after DBS surgery?
A: No, patients typically go home the day after the surgery.

Q: What happens during the DBS surgery?
A: A frame stabilizes the patient's head, an MRI identifies the misfiring brain region, and an electrode is inserted through the skull into the trouble spot in the brain. The electrode connects to a neurostimulator placed under the skin near the collarbone, which modulates brain activity.

Q: Why is the patient kept awake during DBS surgery?
A: The patient is kept awake so the medical team can observe the effects of the stimulation and adjust accordingly for the best outcome.

Q: What is the role of UAB Hospital in DBS procedures?
A: UAB Hospital is a leading institution for DBS with a large database of patient outcomes and a specialized team of 12 movement disorder neurologists, performing 80 to 100 DBS surgeries yearly.