WHAT IS
DEEP BRAIN STIMULATION?
WHAT IS
DEEP BRAIN STIMULATION
Deep Brain Stimulation (DBS) is a treatment option providing personalized, clinically proven control of movement disorder symptoms.
Since its introduction over 15 years ago, DBS therapy has proven to be an effective treatment option for movement disorders such as Parkinson’s disease, essential tremor and dystonia.
DBS can help improve the motor symptoms of movement disorders – such as tremor or shaking, rigidity or stiffness and bradykinesia or slowness of movement. DBS can also improve some non-motor symptoms including mood, energy level, general sense of well-being, sleeping disturbance and pain. DBS therapy can be considered as early as five years after the onset of the disease. When medications start to lose their effectiveness in controlling symptoms, it may be time to consider DBS.
WHAT IS
DEEP BRAIN STIMULATION
1
The stimulator sends the electrical stimulation to restore more normal communication within the brain. It is similar to a pacemaker battery and is typically placed in your chest below your collarbone.
2
The lead is a thin wire is placed in the area of your brain that affects involuntary movement. The lead connects to the stimulator and delivers electrical pulses to help return abnormal brain communication that causes some symptoms back to a more normal state. The system is fully implanted and no leads or the neurostimulator are visible outside their body. The DBS system can be turned off or removed, and the stimulation does not alter brain tissue.
3
After the surgery, the impulses are adjusted by the treating doctor using a programmer to achieve the best control possible control of the symptoms. Patients also receive a patient controller that allows individuals to “fine tune” the stimulator effects. DBS Therapy can either be described as directional or non-directional. Directional leads provide your doctor options to precisely target your therapy to help maximize your “on times” while potentially limiting side effects. The DBS neurostimulator or battery can either be rechargeable or recharge-free. Recharge-free batteries can last up to 3-5yrs and remove the hassle of frequently charging the system.
WHO IS A CANDIDATE FOR
DEEP BRAIN STIMULATION?
MILD SYMPTOMS
oral therapies are controlling symptoms
MODERATE-ADVANCED SYMPTOMS
oral therapies begin to lose effectiveness
SEVERE SYMPTOMS
oral therapies no longer control symptoms
There is a time when DBS will no longer be a therapy option. If you reach a point where medication is no longer having an effect on your symptoms, it’s unlikely that DBS will be an effective therapy.
FOR THOSE WITH PARKINSON’S DISEASE,
DBS therapy can be considered at different points in time,
However, with Parkinson’s disease, it’s often four to five years after onset. You may notice your medications
are wearing off sooner, that you are taking larger or more frequent doses, or you are experiencing side effects
such as dyskinesia as a result of your medications. All of these are signs that it may be time to consider DBS
therapy.
Unfortunately, there is a time when DBS will no longer be a
therapy option. If you reach a point where medication is no longer having an effect on your symptoms, it’s
unlikely that DBS will be an effective therapy.
FOR THOSE WITH ESSENTIAL TREMOR,
DBS therapy can be considered at any time. Generally, patients look to DBS therapy when their tremor is impacting the quality of their life and daily activities. Also, when medications aren’t adequately controlling symptoms and other rehabilitation strategies have become less effective.
FOR THOSE WITH DYSTONIA,
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PHYSICIAN LOCATOR
Find a doctor who specializes in movement disorder symptom relief.
PROVEN BENEFITS OF DBS THERAPY
PARKINSON’S DISEASE PATIENTS
In a study of people with Parkinson’s disease, those who received DBS therapy versus other medical therapy reported significant improvements, which included:
2½ MORE DAILY HOURS OF GOOD QUALITY ON-TIME
(time periods when medications were helping to control symptoms) without dyskinesia, or involuntary movements caused by certain medications
ABILITY TO REDUCE MEDICATION
among patients surveyed at one year
SUSTAINED IMPROVEMENT IN QUALITY OF LIFE
mean increase measured after 3, 6 and 12 months
ESSENTIAL TREMOR PATIENTS
In a study of people with essential tremor, those who received DBS therapy experienced positive results:
A SIGNIFICANT IMPROVEMENT IN TREMOR
allowing patients to return to normal daily activities such as handwriting, pouring and working.
NINE OUT OF 10 PATIENTS REPORTED BEING SATISFIED OR VERY SATISFIED
with the system’s ability to control their symptoms.
AN IMPROVEMENT IN OVERALL QUALITY OF LIFE
including improvements in physical roles, social functioning and mental health.
RX ONLY
Brief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system. Indications for Use: Unilateral or bilateral stimulation of the thalamus, internal globus pallidus (GPi), or subthalamic nucleus (STN) in patients who are at least 18 years old with levodopa-responsive Parkinson’s disease. Unilateral or bilateral stimulation of the ventral intermediate nucleus (VIM) of the thalamus for the management of tremor for patients who are at least 18 years old. Unilateral or bilateral stimulation of the internal globus pallidus (GPi) or the subthalamic nucleus (STN) for the management of intractable, chronic dystonia, including primary and secondary dystonia, for patients who are at least 7 years old.
Contraindications: Patients who are unable to properly operate the system or for whom test stimulation is unsuccessful. Diathermy and magnetic resonance imaging are contraindicated for patients with a deep brain stimulation system.
Warnings/Precautions: Return of symptoms due to abrupt cessation of stimulation (rebound effect), excessive or low frequency stimulation, risk of depression and suicide, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), electromagnetic interference (EMI), proximity to electrosurgery devices and high-output ultrasonics and lithotripsy, ultrasonic scanning equipment, external defibrillators, and therapeutic radiation, therapeutic magnets, household appliances containing magnets, radiofrequency sources, explosive or flammable gases, theft detectors and metal screening devices, activities requiring excessive twisting or stretching, operation of machinery and equipment, pregnancy, nursing, psychotherapeutic procedures, electrocardiograms, cremation, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.
Adverse Effects: Loss of therapeutic benefit or decreased therapeutic response, painful stimulation, persistent pain around the implanted parts (e.g., along the extension path in the neck), worsening of motor impairment, paresis, dystonia, sensory disturbance or impairment, speech or language impairment, and cognitive impairment. Surgical risks include intracranial hemorrhage, stroke, paralysis, and death. Other complications may include seizures and infection. User’s Guide must be reviewed for detailed disclosure.
REFERENCES
™ Indicates a trademark of the Abbott group of companies.
‡ Indicates a third party trademark, which is property of its respective owner.
1 https://www.neuromodulation.com/about-neuromodulation
2,3 https://www.neuromodulation.com/assets/documents/Fact_Sheets/fact_sheet_spinal_cord_stimulation.pdf
4 aboutmypain.co.uk