What You Need to Know About Deep Brain Stimulation (DBS) for Parkinson's

Parkinson’s disease is an age-related neurodegenerative disease, meaning it destroys nerves in certain parts of the brain, leading to a host of symptoms. While there isn’t a cure, there are treatments that can help slow its progression.

At Center for Neurosurgery Las Vegas, board-certified neurosurgeon Dr. Scott Glickman specializes in diagnosing and treating Parkinson’s disease at his Las Vegas, Nevada office. While he offers many treatment options for the condition, he’s passionate about using deep brain stimulation (DBS) as an effective means of controlling the symptoms.

Signs, symptoms, and causes of Parkinson’s disease (PD)

PD is neurodegenerative. Specifically, it’s caused by damage to and death of the neurons in the brain that produce the neurotransmitter dopamine, which regulates mood and movement, among other things. However, while some cases are due to genetics, the exact cause is often idiopathic, meaning “a disease of its own” — there’s no obvious cause.

The signs and symptoms of PD usually begin on one side of your body and then move to both sides, though they often remain worse on the original side. The most obvious symptoms of the early stages include:

• Tremor: often begins in hand or fingers; may shake at rest, unlike essential tremors
• Slowed and changed movement (bradykinesia): steps become shorter and shakier, may drag feet, and may have difficulty getting in and out of chair
• Rigid muscles: often causes “face freezing” and more difficulty walking; stiff muscles painful and limit range of motion
• Impaired posture and balance
• Loss of automatic movements: including blinking, smiling, and swinging your arms when you walk
• Speech changes: voice becomes softer, speech slurred or delivered in a monotone
• Writing changes: difficulty gripping pen, writing small and cramped

Later stages of the disease affect how the brain functions, causing dementia-like symptoms and emotional changes.

• Depression and other emotional changes: therapy may help you cope better
• Emotional changes: including anxiety, fear, and/or loss of motivation
• Loss of sense of smell
• Swallowing problems. saliva accumulates, causing drooling
• Chewing and eating problems: can lead to poor nutrition, weight loss, and choking
• Sleep problems and sleep disorders
• Bladder problems: urinary incontinence
• Constipation: digestive tract slows down
• Sexual dysfunction

There’s growing evidence that at least some of these symptoms can appear in the earliest stages of the disease, almost as a “warning” sign.

Deep brain stimulation

In the past, surgery to intentionally damage and scar the part(s) of your brain that was malfunctioning because of PD was common. However, today, doctors can achieve the same effect by using deep brain stimulation, which uses an implanted device to deliver a mild electrical current to those same areas. The current blocks or changes the abnormal activity that produces symptoms.

The major advantage of DBS is that it’s reversible, while intentional scarring isn’t. This treatment is also almost always an option in later stages of the disease, when levodopa (medication) therapy becomes less effective, as well as in people who have tremors that don’t respond to the usual medications.

The DBS system contains four parts:

1. Leads: wires that end in electrodes implanted in the brain
2. A small pulse generator: supplies the electrical pulses
3. Extension leads: carry electrical pulses from pulse generator to leads implanted in the brain
4. Hand-held programmer device: adjusts the device’s signals; can be turned off and on

The pulse generator is implanted under the skin of the chest below the collarbone. Because it works much the same way as a heart pacemaker, it’s often called “the pacemaker for the brain.”

DBS for Parkinson’s

To treat PD, the DBS system delivers electrical impulses to the area of the brain responsible for the motor symptoms characteristic of the disease. The electrical impulses disrupt the brain’s abnormal activity, helping improve the symptoms.

There are three brain areas that are good targets for patients with Parkinson’s disease:

1. Subthalamic nucleus
2. Globus pallidus internus
3. Ventral intermediate nucleus of the thalamus

Each of these areas plays a role in controlling the body’s movement.

The specific area Dr. Glickman targets is based on your specific symptoms and needs.

If you’re dealing with the debilitating symptoms of Parkinson’s disease and you’re not having success with medication therapy, deep brain stimulation may be a good option. To learn more, and to schedule an evaluation with Dr. Glickman, contact Center for Neurosurgery Las Vegas by calling our office at 702-929-8242, texting us at 725-210-0057, or booking your appointment online.