Deep Brain Stimulation

What is Parkinson’s Disease?

Parkinson’s disease is a progressive, chronic neurological condition. The cardinal symptoms include:

• Tremor
• Rigidity (stiffness)
• Bradykinesia (slowness)

The symptoms result from the deterioration of a small group of cells in the brain, called the substantia nigra. This gradual deterioration also causes a decrease of dopamine, a neurotransmitter that nerves use to send signals to your body from your brain. The disruption in dopamine levels results in the physical symptoms of the disease.

How experienced is the Barrow team in treating Parkinson’s Disease patients with DBS?

We’ve been performing deep brain stimulation (DBS) for as long as it’s been available. Patients from around the country come to see us for this specific condition. 

Good outcomes rely on:

1.) Patient selection

2.) Safe and accurate surgery

3.) Optimal programming of the neurostimulator.

Our partner neurologists are experts at incorporating this therapy to optimize their care of patients with Parkinson’s Disease.  

For Parkinson’s patients, when is DBS appropriate?
Good candidates include patients who have been diagnosed with Parkinson’s for at least four years, and have had motor complications of medical therapy (i.e., motor fluctuations, dyskinesias, refractory tremor) for at least four months.  Candidacy needs to be validated by a neurologist who is a specialist in movement disorders.

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What is essential tremor?

Essential tremor is as neurological disorder that causes uncontrollable shaking, usually in the hands, but it can also affect the head and voice. Symptoms often start gradually, but can quickly worsen over time. While it’s not a dangerous disease, symptoms can become severe and negatively impact the ability to perform simple, everyday tasks.

How experienced is the Barrow team in treating essential tremor patients with DBS?
We’re one of the highest volume centers in the world when it comes to performing DBS for essential tremor. The benefits are remarkable, and are seen soon after surgery. Most patients are able to discontinue taking medicines for essential tremor.

For essential tremor patients, when is DBS appropriate?

Patients who have been diagnosed with essential tremor, who have failed medical therapy can be considered for DBS.

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What is primary dystonia?

Primary dystonia is characterized by involuntary muscle contractions or spasms. Affected areas of the body experience repetitive contractions and twisting movements, often accompanied by pain. This can negatively affect your ability to perform even simple day-to-day tasks. Dystonia can occur in a single muscle, a muscle group or in muscles throughout the entire body.

How experienced is the Barrow team in treating primary dystonia patients with DBS?

We’re one of the leading DBS practitioners in the world. We commonly see primary dystonia patients as part of our program.

For primary dystonia patients, when is DBS appropriate?

Our partner neurologists are experts at managing dystonia with pharmaceutical or nonsurgical means, such as botox. When these strategies fail, we review whether DBS in an option at our bi-monthly, multi-disciplinary, consensus conference.

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What is deep brain stimulation (DBS)?
Deep brain stimulation (DBS) therapy is an FDA-approved surgical treatment for Parkinson’s disease, essential tremor, and other motion disorders. DBS uses a medical device similar to a heart pacemaker, surgically implanted under the skin of the chest.

In addition, a fine wire, called an electrode, is placed deep within the affected area of the brain. The “brain pacemaker” and the electrode are connected by a wire running under the skin from the scalp and neck to the chest. The neurostimulator can then send tiny electrical signals to the electrodes, helping the brain improve motor function.

How experienced is the team with deep brain stimulation?
Barrow Brain and Spine is the highest volume DBS center in the country, and our extensive experience is evidenced by better patient outcomes.

What is the estimated recovery time?
Patients are typically released after an overnight stay. You’ll likely have restrictions after discharge to help expedite the healing process. Expect six weeks to recover, though most patients heal sooner. Post-operative programming of the neurostimulator occurs with the neurologist.

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What is awake DBS?
Awake deep brain stimulation is the original surgical approach for the DBS procedure. During the surgery, local anesthetic is used to numb the areas of the scalp and skull affected by the operation. A metal frame is affixed to the patient’s skull — this helps guide the surgeon’s placement of the electrode. While patients may be lightly sedated during the surgery, they are awake to test the effects of the electrode’s stimulation. Because of this, patients are often aware of brief, loud noises and activity during the procedure.

How experienced is the team with awake DBS?
Aside from our high volume and proven patient outcomes, we remain committed to this procedure, doing more DBS surgery for Alzheimer’s Disease clinical trials than any other center in the United States.

What is the estimated recovery time?
While each case is different, most patients will be admitted to the hospital for an overnight stay, and may be released to go home the following morning.

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What is asleep DBS?
At Barrow, we’re at the forefront in developing and validating this new approach to the DBS procedure. Patients now have the option to undergo DBS surgery under general anesthesia. This improves patient comfort, reduces the duration of the surgery and allows Parkinson’s patients to maintain their regular medicine regime leading up to the procedure.

Asleep DBS uses MRI to pick a target, followed by intraoperative computed tomography (CT) scanning to verify the accurate placement of the electrodes to that target. The premise of asleep DBS is the ability to see the target on MRI. Unfortunately, DBS targets cannot be seen on CT scans, and we therefore typically recommend awake surgery for patients who cannot undergo MRI.

How experienced is the team with asleep DBS?
The neurologists and neurosurgeons at Barrow have been chief contributors, validating the outcomes of asleep DBS. Because of this, more than 90% of Barrow patients now choose asleep over awake. Based upon our prospectively collected data, we anticipate transitioning to performing exclusively asleep DBS.

What is the estimated recovery time?
As with awake DBS, patients stay in the hospital overnight after the procedure and are typically able to go home the next morning.

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