In September’s Live Well Today webinar, Dr. Soania Mathur and Dr. Joohi Jimenez-Shahed discussed the most recent developments in deep brain stimulation (DBS) as a Parkinson’s treatment.   

You can watch or listen to the webinar below. Subscribe to our YouTube page so you can be notified whenever we upload new content.

SHOW NOTES  

DBS: A Brief Overview

Deep brain stimulation is a surgical intervention that involves implanting small, thin wires into specific parts of the brain. These wires deliver electrical signals from a neurostimulator to areas of the brain affected by Parkinson’s. This stimulation helps control some of the cardinal motor symptoms of Parkinson’s, such as tremor, rigidity or stiffness, and bradykinesia (slowness). 

All DBS systems have the same three basic components: the wire, the extension wire, and the battery. A thin wire (also called the “lead” or “electrode”) is connected to an extension wire, which is connected to a battery. The battery, sometimes referred to as a “neurostimulator” or an “implanted pulse generator,” is similar to a cardiac pacemaker and is implanted in the chest.  

Once these components are implanted, a clinician programs the DBS system in order to supply the stimulation/treatment as effectively as possible for the individual person with Parkinson’s.   

When should DBS be explored? 

DBS is not a replacement for medications or a Parkinson’s cure, but it can help you manage symptoms when your medications alone are not giving you the symptom relief you need.

“DBS is an excellent therapy for the right person at the right time,” Dr. Jimenez-Shahed said during the webinar. “And that might be different timing for different people.” She said that generally speaking, DBS can be explored when people with Parkinson’s who have been on medication start experiencing troublesome ON/OFF fluctuations and dyskinesia, or when impactful symptoms like tremor are no longer adequately controlled by medication. 

To determine if a person with Parkinson’s will benefit from DBS, providers conduct several preoperative examinations. One of these is ON/OFF testing, which demonstrates how well a person’s symptoms respond to medications like levodopa. For this test, the person with Parkinson’s refrains from taking their medications for a certain length of time and then undergoes an examination. This allows providers to see what the person’s symptoms look like during an OFF state. Then, the person with Parkinson’s will take their medications, and the providers will re-examine them to see how the medication affects their symptoms.  

“What we generally say is that if a symptom gets better with levodopa–if it seems to be better controlled in the ON state–it is likely that the symptom will be treated with deep brain stimulation,” Dr. Jimenez-Shahed said. “What DBS does is keep people ON longer.” 

The Evolution of DBS 

The U.S. Food and Drug Administration (FDA) first approved deep brain stimulation to treat tremor in people with Parkinson’s in 1997. In 2002, DBS was also approved to treat advanced symptoms of Parkinson’s. <span data-ccp-props="{"201341983":0,"335557856":16777215,"335559739":340,"335559740":276