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How is deep brain stimulation (DBS) used to treat Parkinson's disease?

In some people, medications do not adequately control the disabling symptoms of Parkinson's disease. These people may be eligible for a neurosurgical procedure called deep brain stimulation (DBS). DBS has become an important tool in the treatment of Parkinson's disease. In DBS, neurosurgeons implant a device that acts like a pacemaker for the brain, reducing or eliminating abnormal brain signals in regions that are overly active in Parkinson's disease. DBS is not a cure for Parkinson's disease, and does not slow its progression. But for many, it can dramatically reduce some symptoms of Parkinson's disease and greatly improve quality of life. Continuous monitoring of the electrical activity of the brain and spinal cord during surgery diminishes the risk of neurological injury.

In advanced cases of Parkinson's disease, surgery may be an effective treatment option. A common surgical procedure for Parkinson's is deep brain stimulation. This procedure implants an electrode in your brain and the controlling device in your chest. A wire connects the implants. The electrode can then stimulate the brain when necessary to control symptoms. This can be effective at controlling tremors and other involuntary movements caused by Parkinson's disease. There are risks associated with brain surgery, though, and it's not an option for everyone.

Deep brain stimulation (DBS) can be used to treat Parkinson's disease with positive results.  
Jeanne Morrison, PhD
Family Medicine

Deep brain stimulation (DBS) uses electrodes surgically implanted into part of the brain. The electrodes are connected by a wire under the skin to a small electrical device called a pulse generator that is implanted in the chest beneath the collarbone. The pulse generator and electrodes painlessly stimulate the brain in a way that helps to stop many of the symptoms of Parkinson's disease. DBS has now been approved by the U.S. Food and Drug Administration and is widely used as a treatment for Parkinson's disease.

DBS can be used on one or both sides of the brain. If it is used on just one side, it will affect symptoms on the opposite side of the brain. DBS is primarily used to stimulate one of the three brain regions: the subthalamic nucleus, the globus pallidus, or the thalamus. However, the subthalamic nucleus, a tiny area located beneath the thalamus, is the most common target. Stimulation of either the globus pallidus or the subthalamic nucleus can reduce tremor, bradykinesia, and rigidity. Stimulation of the thalamus is useful primarily for reducing tremor.

DBS usually reduces the need for levodopa and related drugs, which, in turn, decreases dyskinesias. DBS also helps to relieve on-off fluctuation of symptoms. People who initially respond well to treatment with levodopa tend to respond well to DBS. While the benefits of DBS can be substantial, it usually does not help with speech problems, freezing, posture, balance, anxiety, depression, or dementia.

This answer is based on source information from the National Institute of Neurological Disorders and Stroke.

Audrey K. Chun, MD
Geriatric Medicine
Using imaging technology such as magnetic resonance imaging (MRI) or computed tomography (CT), a neurosurgeon can pinpoint the part of the brain responsible for sending the abnormal electrical signals that cause the poor balance, loss of coordination, tremors, and rigidity characteristic of Parkinson's disease (PD). A neurostimulator is implanted near the collarbone and thin, flexible wires with electrodes at one end are guided up and into the brain, where they stimulate brain tissue to block these abnormal nerve signals.

Stimulation of specific areas in the brain can reduce tremor, improve fluctuations in motor performance that afflict patients with advanced PD, ease stiffness, and eliminate abnormal movements caused by long-term use of levodopa.

Levodopa is a standard PD medication, and it has been around for many years. However, some PD patients either become resistant to the medication or have side effects that keep them from taking it. Invasive, deep brain stimulation (DBS) has proved to be an effective alternative for patients in need of symptom management. As far as we can tell, DBS can improve symptoms for many years, 7 to 10 years in some cases. Patients can enhance the effectiveness of DBS and generally improve their health and overall quality of life even if they don't get DBS by exercising regularly. The bottom line for all PD patients is to keep moving and not let the condition turn them into a sedentary person. A lack of stretching and muscle exercise is thought to worsen the effects of PD.
Thin wires (leads) are placed into an area of the brain called the subthalamic nucleus (STN) or the globus pallidus pars interna (GPi) and then connected to batteries that are placed in the chest. These leads deliver electrical stimulation to the area which allows the brain to control movement more normally.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.