Deep Brain Stimulation
DBS is an innovative surgical treatment that can help patients suffering from Parkinson’s disease, Essential Tremor and Dystonia who have not had adequate response to medications. These neurological movement disorders appear to be associated with abnormal circuitry between the basal ganglia and other brain regions involved in controlling movement. We can change the rates and patterns of activity in each of these illnesses by implanting electrical stimulators into specific anatomical targets. Once implanted, the stimulator’s settings (pulse width, frequency and amplitude) are programmable and can be easily adjusted by a trained physician or nurse with no discomfort to the patient.
For patients with Parkinson’s disease (PD) and for those with Dystonia, stimulators are implanted on both sides of the brain. In PD, the stimulator is placed in either the subthalamic nucleus (STN) or the globus pallidus interna (GPi). In dystonia, the GPi is generally the target. In Essential Tremor (ET) the anatomical target is the thalamus. In ET, it is usually only necessary to implant a stimulator on one side of the brain (generally on the side of the brain opposite the patient’s dominant hand).
Appropriately selected patients may benefit dramatically from DBS. Benefits of DBS include the fact that it is both adjustable and reversible. Should new therapies become available in the future, patients can have the DBS system removed and try newer treatment alternatives. If, however, a patient is not an appropriate candidate for DBS, an ablative procedures such as pallidotomy or thalamotomy may still be possible.