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How can DBS help me?
DBS uses a small medical device that is implanted into your body, with leads implanted into the brain, which stimulates specific areas of the brain.
DBS is not a cure, but the stimulation may help improve many of the day-to-day symptoms and may also result in fewer medicines to take each day or reduced dosages of your medications.
Because your medicine may be reduced, you could also have a reduction in some of the medication-related side effects such as motor fluctuations (ON-OFF condition) and involuntary movements, also referred to as dyskinesia. For people living with Dystonia, Essential Tremor or Parkinson’s, DBS therapy may reduce some of the symptoms and improve daily life.
How does Deep Brain Stimulation work?
Deep Brain Stimulation surgery
Is the procedure safe?
While there’s risk with every surgery, DBS isn’t a new therapy, and for many people living with Parkinson’s, Dystonia and Essential Tremor, DBS therapy is a normal part of their treatment journey. More than a quarter century of clinical trials and patient experiences have tested the safety and effectiveness of treating Parkinson’s, Dystonia and Essential Tremor with DBS. Hundreds of thousands of patients like you are already experiencing the benefits.
Dr. Jens Volkmann, MD Phd, Chairman and Professor of Neurology at University of Wurzburg (Germany) and global thought leader in DBS discusses the safety of Deep Brain Stimulaton.
Is DBS effective?
Not all movement disorder’s patients are affected by the disease in the same way. The severity, type, and recurrence of any symptom will vary by individual. As will his or her response to DBS treatment. But quite often, DBS allows movement disorder’s patients to reduce the amount of medicine they take and live free from disruptive side effects such as uncontrolled movements, incontinence, and moodiness.
96% Patient Satisfaction
If given the chance, 96% of DBS patients would choose to do it again.1
More “ON Time”
DBS provides roughly 8 to 10 hours of “ON time,” giving you control and independence to live your life without rigidity or freezing.2,3,4
Sustained Results
Marked improvements in motor function are sustained for at least 5 years.4
What is the journey of DBS?
Your DBS journey can involve 5 phases, so the whole journey can take some time from start to finish. You will have support throughout and after your DBS journey from your specialist team.
1. Explore your options
The first step of your journey is understanding if you could be an eligible candidate. Speak to your nearest Neuro-centre to see if DBS is a solution for you or request a referral from your General Practitioner to speak to a movement disorder Neurologist.
2. Have a DBS surgery evaluation
In this stage, you’ll go through a thorough series of screenings to ensure that you’re a good candidate for DBS. These may include a neurological consultant, ON/OFF testing, a neuropsychological evaluation, a general health screening, brain imaging, and routine lab work.
3. Lead implantation surgery
The first step in the surgical process is to place the leads in the brain. During surgery, your specialist may perform tests to ensure that the leads are positioned correctly by asking you to move your arms and legs or make other simple movements. Other surgeons perform the test whilst you are asleep. The surgery can range from 4-8hrs in length. Afterwards, expect to stay in the hospital at least overnight for monitoring.
4. Stimulator implantation
This is a surgical procedure that may happen at the time the leads are implanted or several weeks after. When the stimulator is implanted, you’ll be under general anaesthesia, and the stimulator will be connected to your leads via the extension.
5. Programming and Optimisation
Following surgery and recovery, your DBS system will be turned on and the stimulation settings will be customised for you. In the months following implantation, you’ll work closely with your specialist team to make adjustments to your stimulation settings and your medicine to help best control your symptoms.
Aftercare
- DBS can be a life-changing experience, but it does not happen overnight. It can take anywhere from a few months to almost a year for your specialist team to adjust the device settings and medications to fit your unique needs.
- After surgery, postoperative outpatient assessments are conducted regularly, particularly over the first year, by specialist movement disorder team who optimise your stimulation programme. Once you have obtained optimal response to your DBS system, you will have less dependency on consultancy appointments, follow up appointments will be reduced. You will be provided with care instruction packages, such as ‘How to re-charge my Device?’. You can find all the brochures here.
- But always remember your specialist team are there to help and provide guidance, even if you have achieved optimal response to your DBS system, we are with you every step of the way.
Expectation goals
As with all types of surgery, there is always a degree of risk of complications, it is important to remember this may not be a solution for everyone. Your specialist team will work with you to understand the best treatment and your personal goals from DBS surgery. It is important to keep in mind that despite all the efforts of your specialist team to select the best treatment adapted to you, patients do not all experience the same outcome. DBS is not a cure but can help you to achieve a better quality of life.
Keep in mind the following:
- DBS Goals: Before embarking on the DBS journey, it is important to set DBS goals that are realistic and achievable. You will work closely with your specialist team to identify these goals. It may take some time to achieve the best therapy for you.
- Goal Setting for Parents & Carers: Parents and Carers will be involved in the goal setting.
- Approved for DBS: Once you are accepted for DBS surgery, your specialist team will discuss with you the risks and benefits of DBS surgery
Managing your expectations:
- DBS will not be able to correct your speech, balance or cognitive function
- After DBS surgery you will most likely have medicine alongside your treatment. Although, this will slowly be reduced as your stimulation in the device increases. For most patients, there is an expected decrease of medication of at least 30% *
FAQ
Have questions about DBS? We’ve got you covered. Below are some of the top questions.
- Is there an optimal point in the course of the disease at which to consider DBS?
- Will I be able to reduce my medication as I achieve optimal programming?
- How long will I be in hospital? Will my head be shaved in hospital prior to surgery?
- How long will the recovery period be, post hospital discharge?
- What does it feel like to live with an implanted DBS system?
References:
1. Knoop et al. Bridging the gap in patient education for DBS surgery for Parkinson’s disease. Parkinson’s Disease. 2017. 2017: 1-6.
2. Okun et al. Subthalamic deep brain stimulation with a constant current device in Parkinson’s disease: An open-label, randomised, controlled trial. Lancet Neurology. 2012. 11: 140 – 149.
3. Timmerman et al. Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson’s disease (the VANTAGE study): a non-randomized, prospective, multi-centre, open label study. Lancet Neurology. 2015. 14: 693 – 701.
4. Krack et al. Five-year follow up of bilateral stimulation of the subthalmaic nucleus in advanced Parkinson’s disease. N Eng J Med. 2003. 349: 1925 – 1934.
* Vitek JL, Jain R, Chen L, et al. Subthalamic nucleus deep brain stimulation with a multiple independent constant current-controlled device in Parkinson’s disease (INTREPID): a multicenter, double-blind, randomised, sham-controlled study. Lancet Neurology. 2020;19(6):491‐501. doi:10.1016/S1474-4422(20)30108-3
This material is for informational Purposes only and not meant for medical diagnosis. This information does not constitute medical or legal advice, and Boston Scientific makes no representation regarding the medical benefits included in this information. Boston Scientific strongly recommends that you consult with your physician on all matters pertaining to your health.
CAUTION: The law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at www.IFU-BSCI.com. Products shown for INFORMATION purposes only and may not be approved or for sale in certain countries. This material not intended for use in France.