7 Things to Know About Deep Brain Stimulation for Parkinson’s Disease

Although there’s no cure for Parkinson’s disease, there are medications that can help patients better cope with the symptoms of the condition. If patients no longer find these medications helpful, they have the option of trying deep brain stimulation. We’ve put together a list of things you should know about this treatment technique using information from the National Parkinson’s Foundation and the National Institute of Health.

1. It’s a surgical procedure. 
Deep brain stimulation is a surgical procedure used to help people who suffer from Parkinson’s disease and other neurological movement disorders such as essential tremor and dystonia.

2. It’s used when medications fail. 
The procedure is only used for patients whose Parkinson’s symptoms can no longer be controlled with medication.

3. It doesn’t damage the brain. 
Deep brain stimulation doesn’t destroy any brain tissue or cells, it blocks the electrical signals in the brain which bring about tremors.

MORE: A Parkinson’s disease patient talks about his deep brain stimulation procedure

4. It involves a neurostimulator. 
A surgeon will implant a battery-operated neurostimulator in the brain which sends out electrical impulses to the parts of the brain controlling movement after identifying the target areas using MRI or CT scans.

5. There are three components. 
There are three components to the neurostimulator: the battery pack which is inserted in the chest, stomach, or near the collarbone and is around the size of a stop watch; the lead or electrode, which is inserted into the targeted area of the brain; and the extension which is the wire running from the lead to the neurostimulator, which fits under the skin and runs down the neck.

6. It can be removed. 
If the deep brain stimulation is found to be ineffective, the components can be easily removed without any damage to the brain.

7. It can reduce the number of medications needed. 
Patients who have deep brain stimulation report a reduction in the medications they need to take to control their Parkinson’s disease symptoms.

MORE: Researchers identify factors of deep brain stimulation outcomes for Parkinson’s patients

Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

One comment

  1. Does tunneling through brain parenchyma to implant DBS leads cause subtle verbal impairment? In 2013, the following letter to the editor of the NEJM questioned the lack of significant loss of verbal fluency reported in EARLYSTIM [1], in contrast to that seen in prior trials:
    The investigators in the Controlled Trial of Deep Brain Stimulation in Early Patients with Parkinson’s Disease (EARLYSTIM) found that “no significant between-group differences were observed for cognitive assessments” when they compared patients who received subthalamic neurostimulation for Parkinson’s disease with those who received medical therapy alone. In a recent review, [2] Okun described a meta-analysis finding that “the most common cognitive side effect of deep-brain stimulation was a decrement in verbal fluency.[3] Impaired verbal fluency is characterized by communication difficulties and by problems in generating word lists.” Okun and colleagues also conducted a study that showed that a “decrease in verbal fluency is an effect of surgical electrode implantation, not an effect of stimulation.”[4]

    Did the EARLYSTIM investigators use a technique of lead placement that avoided impairing verbal fluency, or were the tests they used for assessing cognitive outcomes not sensitive instruments for measuring verbal fluency?

    References
    1) Keller DL. Neurostimulation for Parkinson’s disease with early motor complications. N Engl J Med. 2013 May 23;368(21):2037-8. doi:10.1056/NEJMc1303485#SA2. PubMed PMID: 23697522.
    2) Okun MS. Deep-brain stimulation for Parkinson’s disease. N Engl J Med 2012;367:1529-1538
    3) Parsons TD, Rogers SA, Braaten AJ, Woods SP, Troster AI. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: a meta-analysis. Lancet Neurol 2006;5:578-588
    4) Okun MS, Gallo BV, et al. Subthalamic deep brain stimulation with a constant-current device in Parkinson’s disease: an open-label randomised controlled trial. Lancet Neurol 2012;11:140-149

    The EARLYSTIM investigators replied as follows:
    Keller raises questions regarding the effect of neurostimulation on verbal fluency shown in all controlled studies. We assume that verbal fluency is also significantly worse in patients in the neurostimulation group than in those in the control group in EARLYSTIM. Therefore, we have added a second protocol, EARLYSTIM-speech, to compare standardized speech recordings at baseline and at 24 months. This study will provide more information not only on the frequency and severity of changes of word fluency but also on the effect of these changes on communication in real life.
    The EARLYSTIM-speech add-on study is nearly completed and will report its findings soon.

Leave a Comment

Your email address will not be published. Required fields are marked *