Understanding Deep Brain Stimulation for Parkinson's Disease and Other Movement Disorders

If you or a loved one is affected by a movement disorder, such as Parkinson's disease, you know the special challenges these conditions pose. And you're not alone: Nearly one million people in the United States are living with Parkinson's disease, a number that is expected to rise to 1.2 million by 2030.

Physicians affiliated with Memorial Hermann Mischer Neurosciences possess a comprehensive understanding of movement disorders and offer the most advanced treatments, including deep brain stimulation (DBS). Mischer Neuroscience Associates neurosurgeon Sam Javedan, MD, who is affiliated with Memorial Hermann The Woodlands Medical Center and Memorial Hermann Cypress Hospital, answers some frequently asked questions about DBS.

Q: What is deep brain stimulation (DBS)?

Dr. Javedan: DBS is a form of therapy designed to alleviate motor symptoms of some common movement disorders, including Parkinson's disease and essential tremor. The therapy is delivered through an implanted device that delivers very low amplitude electrical current to a very specific part of the brain, causing the function of the brain to change. This can help relieve stiffness, involuntary shaking and some of the other common motor symptoms of these movement disorders. While DBS is not a cure, it can significantly improve a patient's quality of life.

Q: How might a patient with Parkinson's disease benefit from DBS?

Dr. Javedan: The therapy has been shown to be very effective in relieving Parkinson's patients of key symptoms: tremor (involuntary fine shaking movement, typically of the arms and hands); rigidity (muscle stiffness in the limbs); bradykinesia (slowness of movement) and drug-induced dyskinesia (a wavy, dance movement of the arms and the body). It can also reduce daily medication requirements.

It's very important to identify, up front, what's really affecting a patient's quality of life. If their quality of life is being impacted by those things, they will likely be great candidates for DBS. If their quality of life is being affected by other symptoms, such as voice or cognitive problems, they likely will not benefit.

Q: What can a patient undergoing DBS expect?

Dr. Javedan: The patient undergoes surgery, which typically takes about 2 hours, during which the surgeon implants a very thin wire (or two) to the part(s) the brain that have been identified as most likely to respond. After surgery, the patient will typically spend 1 night in the hospital.

Then, 2 or 3 weeks later, the patient will undergo a very brief outpatient surgery to implant the battery, just under the skin below the collar bone. No overnight stay is required. A couple of weeks later, the patient will visit the neurologist's office to have the device turned on and programmed via a remote control device. This usually takes about 45 minutes.

Right away, we typically see a marked impact on symptoms, including decreased tremor and faster movement. Then gradually, over the next several weeks, the patient will notice an additional reduction of symptoms. Within a month or two of activation, almost all of our Parkinson's patients are ready to reduce their medicines, a tremendous relief of a burden for them and their caregivers. The average drug reduction for DBS patients is 62 percent.

Q: Is the treatment reversible?

Dr. Javedan: With DBS, you can always turn the device down to zero voltage and essentially return the brain to its former condition.

Q: Are the results long-lasting?

Dr. Javedan: In my experience, the benefits never stop accruing to patients unless or until either one of two things happen-they have some other disease that impacts their quality of life (such as severe heart disease or cancer) or they develop other non-motor symptoms of Parkinson's disease that DBS does not affect.

To view Dr. Javedan's previously recorded webinar on treatment options for movement disorders, visit memorialhermann.org/movement-disorders-treatment. Need an appointment with a neurologist or neurosurgeon? Call 713.897.5900. For more information, visit memorialhermann.org/movement-disorders.