A surprising fact about Deep Brain Stimulation (DBS) surgery technology is that human DBS leads (the wire implanted in the brain and connected to the neurostimulator) and their four shiny, tiny contacts have not really changed much over the last two decades. One reason for the durability of DBS lead design has been the long-term beneficial effects of using this simple approach.
We are blessed to have the National Parkinson Foundation’s terrific free 1-800-4PD-INFO Helpline staffed by nurses and social workers with experience in the field. Recently, many people have called the Helpline after seeing a video declaring focused ultrasound therapy as “the scalpel-less cure for Parkinson’s disease.” The Helpline staff thought it important to objectively explore this therapy and discuss whether it is indeed a scalpel-less cure.
What are the facts?
- Deep brain stimulation (DBS) is a surgical procedure used to treat a variety of disabling neurological symptoms—most commonly the debilitating symptoms of Parkinson’s disease (PD), such as tremor, rigidity, stiffness, slowed movement, and walking problems.
- The procedure is also used to treat essential tremor, a common neurological movement disorder.
- DBS does not damage healthy brain tissue by destroying nerve cells. Instead the procedure blocks electrical signals from targeted areas in the brain.
A huge question facing Parkinson’s disease patients and clinicians has been “What is the best target for deep brain stimulation (DBS)?” Over the years, two main brain regions have emerged as possibilities: the subthalamic nucleus (STN) and the globus pallidus interus (GPi). Though each target has had defenders, most centers have gravitated toward utilizing only STN DBS. A series of recent trials, however, will likely change this simple practice pattern into a more complex and tailored approach.
There has been a great deal of recent controversy as to whether a MRI can be safely performed in Parkinson’s disease patients (PD) with deep brain stimulator devices. The overarching worry has been that the MRI machines will heat the DBS, and this will in turn result in an irreversible injury to the brain. Despite these worries there have been surprisingly few cases of MRI-related heating injuries associated with DBS devices.