People living with Parkinson’s disease commonly experience tremors, stiffness and involuntary movements, and medications don’t always help everyone. But a treatment called deep brain stimulation (DBS) offers hope.

What Is DBS?

“DBS is a therapy for selected patients where a surgeon implants electrodes into specific parts of the brain,” says Tasneem Peeraully, M.D., a movement disorders neurologist at the Hackensack Meridian Neuroscience Institute at JFK University Medical Center.

• These electrodes are then connected to a generator implanted underneath the skin of the chest near the collarbone.
• A movement disorders neurologist can then remotely manipulate the electricity moving through the electrodes in the brain to reduce motor symptoms of Parkinson’s, like stiffness, slow or involuntary movements.

There are specific pathways in the brain associated with Parkinson’s. The disorder causes disorganized electrical signals along these pathways. Electrodes implanted with DBS can disrupt these rogue signals, which in turn reduces symptoms.

Who Should Consider DBS?

Dr. Peeraully says certain Parkinson’s patients with uncontrollable tremor can benefit from DBS when:

• Medication is not effective at controlling tremor
• Medication wears off well in advance of the next dose
• Medication is causing disruptive side effects

Not all Parkinson’s patients may benefit from DBS. Those considering DBS will undergo a 3-4 hour neuro-psychological exam to understand if they are a good candidate for the treatment.

“DBS is not ideal for patients who are in cognitive decline, have untreated psychological challenges, or issues that aren’t motor-related,” says Vanessa C. Milano, M.D., neurosurgeon at the Hackensack Meridian Neuroscience Institute at JFK, adding that DBS can’t help with all Parkinson’s symptoms. “For some Parkinson’s patients, their primary symptoms may be trouble with memory or speech. Unfortunately, DBS does not help with these symptoms. However, through research and first-hand experience I have seen improvements in sleep, pain, and mood in patients who have undergone DBS for their tremor, slow movements, or stiffness.”

Is There a Downside to DBS?

When DBS is carefully chosen for the right patients, this treatment is safe and effective.

Generally, risks and potential side effects are mild and reversible. Patients sometimes experience short-term numbness, tingling or confusion immediately after implantation of the electrodes.

“DBS does require surgery, so there are always possible issues that may be faced with any surgery, such as infections or bleeding,” Dr. Peeraully says.

How Effective Is DBS?

Parkinson’s disease is a progressive disorder, and DBS won’t halt the disease entirely. “But for many patients, DBS can be effective for decades,” says Dr. Peeraully.

While DBS is not meant to replace medications, many people see a reduction in the medication they need to manage their Parkinson’s.

DBS can also help improve symptoms of:

• Tremor
• Stiffness
• Slowness
• Dyskinesias (uncontrolled, involuntary movement)

“DBS is not a cure, but it does help improve quality of life by allowing patients to perform daily activities more easily and even return to some of the hobbies they enjoyed before their diagnosis,” Dr. Milano says.

Dr. Peeraully agrees: “It’s a good therapy for the right candidate.”

Next Steps & Resources:

• Meet our sources: Tasneem Peeraully, M.D., and Vanessa C. Milano, M.D.
• To make an appointment with a movement disorders neurologist near you, call 800-822-8905 or visit our website.
• Learn more about care for Parkinson’s disease at Hackensack Meridian Health.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.