DBS for Parkinson’s disease

DBS
Springfield, Ore. neurologist Dr. Sara Batya referred her Parkinson's patient, Colin Halstead, to OHSU for DBS.

 

Deep brain stimulation is a well-established therapy for movement disorders. OHSU neurosurgeon Kim Burchiel, M.D., pioneered its use in the United States in 1991 with the first successful DBS surgery for Parkinson’s. Today, OHSU is a high-volume center with the longest history of DBS in the United States, having completed more than 1,000 procedures. Our multidisciplinary team works together to ensure outstanding surgical outcomes for patients from around the world.

First to offer “asleep” DBS

In 2011, Dr. Burchiel developed a new method of implanting DBS electrodes to treat Parkinson's and essential tremor, under general anesthesia. OHSU was one of the first centers to offer deep brain stimulation under general anesthesia and remains one of the few offering “asleep” DBS.

Surgery under anesthesia allows for more precise placement of electrodes in the brain as our experienced neurosurgical team matches the high-resolution, pre-surgery MRI scan with preoperative and intraoperative CT scans to locate the target exactly, without the trial and error necessary with patient feedback. Outcomes for asleep deep brain stimulation are equally good, and patients are more comfortable with the procedure. Patients with Parkinson’s can take their medication the day of their DBS surgery. OHSU no longer performs awake DBS surgery.

DBS for motor function improvement

One clinical study showed that DBS for Parkinson's with medications gave patients more than five hours of additional “on” time each day without dyskinesia. Patients significantly reduced their use of dopaminergic medication, potentially reducing side effects. This study also found that scores on a test of Parkinson’s-related qualify of life improved by more than 20 percent after six months, versus optimal medical therapy.¹

Another prospective, double-blind crossover study showed DBS increased patients’ periods without symptoms or excessive involuntary movement from 27 percent to 74 percent of the waking day for subthalamic stimulation, and from 28 percent to 64 percent for pallidal stimulation.² In another study, the improvements in motor symptoms after subthalamic stimulation lasted up to 5 years.³

View DBS data and clinical outcomes from Medtronic

Quality of life improvement

Research shows deep brain stimulation improves patients’ quality of life more than medication alone.¹ Benefits may include:

  • Five (5) more hours of good movement control per waking day versus medication alone. No limitations on sleep position, intimacy, bathing or swimming, or clothing.
  • 24-hour therapy – does not wear off overnight as medications can.
  • Simplified medication routine and fewer potential drug-related side effects.
  • No daily maintenance (unless rechargeable system is chosen).

Deep brain stimulation is reversible, unlike other surgical options such as pallidotomy and thalamotomy. Patients may have the system turned off, but components may remain in place for future treatment options.

Learn more about DBS at OHSU, including detailed patient selection criteria, treatment timelines and how we work with you to provide the best care for patients with Parkinson’s.

¹ Medtronic DBS Therapy for Parkinson's Disease and Essential Tremor Clinical Summary, 2013
² The Deep-Brain Stimulation for Parkinson's Disease Study Group. Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus pallidus in Parkinson's disease. N Engl J Med. 2001;345:956-63.
³ Krack P, Batir A., Van Blercom N, et al. Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson's disease. N Engl J Med. 2003;349:1925-1933.

Is your patient a candidate for DBS?

Parkinson's patients who benefit from levodopa and have adverse effects from medication levels are good candidates for DBS. Patients with "Parkinson's plus" conditions, such as multiple system atrophy, progressive supranuclear palsy or vascular parkinsonism will not benefit, and DBS will likely worsen symptoms. Patients must be referred by a primary care physician, neurologist or neurosurgeon.

Learn more about patient selection criteria.

Refer a patient

If you have questions, or would like to refer a patient, please call the OHSU Physician Consult & Referral Service at 800 245-6478 or fax 503 346-6854.

Request a patient evaluation