When you think of Parkinson’s disease, what comes to your mind? For many people, actor Michael J. Fox has become the “face” of Parkinson’s disease. While his Parkinson’s disease journey is not typical–he developed the condition at a much younger age than most patients–his foundation concentrates on research into Parkinson’s disease, including deep brain stimulation. What exactly is that, and how does it help Parkinson’s disease?
Parkinson’s disease is a condition in which neurons that control motor function die before the rest of the surrounding brain tissue, causing stiffness, shaking, shuffling gait and loss of balance. Advanced cases can cause sleep deprivation, memory loss, speech impairment, and behavioral changes. Parkinson’s disease can be found in all genders, though it is more common in men over the age of 60.
Deep brain stimulation treats Parkinson’s disease by using a small implanted power unit and electrodes to send electrical impulses into the brain tissue affected by the disease. Because the brain works on electricity moving through nerve cells, these impulses attempt to stimulate normal brain function and control the symptoms.
Should I consider deep brain stimulation?
The typical candidate for this procedure has been diagnosed with Parkinson’s disease for four years and/or is experiencing complications or side effects of levodopa (dopamine replacement) oral medication which significantly reduce the patient’s quality of life. In addition, deep brain stimulation will be effective for those with a good response to levodopa. Because it is a delicate procedure involving invasive surgery and implanting a device in the brain, deep brain stimulation requires an extensive preoperative consultation. You may be asked to undergo various tests or scans, both to check whether or not your condition justifies the procedure and to help your doctors prepare to perform it. Nonsurgical alternatives are usually tried first, with deep brain stimulation surgery being tried only after those other options have proved ineffective.
What does the procedure involve?
In deep brain stimulation surgery, your doctor will implant two main components into your body. The first is a small power pack and control device, similar to a cardiac pacemaker. This will sit in the chest area and is connected to the brain by the second component, the electrode array. The electrodes look like a long wire; they run from the power pack, under the skin of the neck, and into the brain.
Once the surgery is completed and the patient has recovered, the surgical team will remotely activate the device and begin testing it to find the ideal settings. The remote control for such a device is highly specialized. Depending on the setting you need, you may be given a simpler version that will only work with your device and have only certain controls such as “on” and “off.” Your healthcare team will work with you to help you learn how to operate this device.
Risks and drawbacks
Deep brain stimulation is a procedure requiring advanced invasive surgery into the brain and near the delicate arteries of the neck, as well as implantation of a foreign device into the body. While these procedures present some significant risk , the actual rate of complications from the surgery is minimal. Other side effects include possible infection, damage to the tissue around the implant, and stroke.
This is a treatment, not a cure. The same symptoms that respond to levodopa (such as tremor, stiffness and shuffling gait) can improve significantly but will not entirely vanish.
For many with Parkinson’s disease, deep brain stimulation can be a way to find relief from the debilitating symptoms of the condition. If you think you or a loved one may be a candidate, find a highly qualified and reputable surgical team and facility to ensure that the procedure is both safe and successful.
Steve Schadendorf, MD
Founding Medical Partner
Dr. Schadendorf is a board certified neurologist who specializes in vascular neurology at Bass Medical Group. Dr. Schadendorf is a Founding Medical Partner and Medical Director of the Neuromedicine Channel at Doctorpedia.