6Deep Brain Stimulation and Parkinson ’ s
DBS does not seem to directly affect non-motor symptoms , such as sleep problems or pain . But , because it improves motor symptoms , DBS might improve some non-motor symptoms as well . If DBS relieves nighttime tremor or difficulty turning over in bed , for example , you might naturally sleep more soundly and have less pain .
Who May Be Eligible for DBS
DBS doesn ’ t work for everyone . And because it involves brain surgery and living with a device in your body , doctors are careful to recommend DBS only when it ’ s most likely to offer benefit and least likely to cause side effects or complications .
Deep brain stimulation typically works best in people who :
Have had a Parkinson ’ s diagnosis for at least four years experts consider DBS to be “ too early ” if motor symptoms , such as tremor , slowness and stiffness , are adequately controlled and medications don ’ t cause unacceptable side effects . “ Too late ,” on the other hand , could be if , as disease progresses , balance problems or significant cognitive changes develop . These symptoms do not respond to DBS and could potentially offset any benefits .
DBS also does not work for people who have atypical parkinsonism , or “ Parkinson ’ s plus ” syndromes , such as Multiple System Atrophy ( MSA ), Progressive Supranuclear Palsy ( PSP ) and others . These diseases can mimic PD early on but “ declare ” themselves within a few years by not responding to levodopa ; progressing more quickly ; or bringing earlier , more severe symptoms . Atypical parkinsonism can be hard to separate from Parkinson ’ s , especially in the early years . But newer tests that detect abnormal alphasynuclein protein , the hallmark of PD , in the spinal fluid or skin may , in some cases , help your doctor make a more accurate diagnosis .
Benefit from levodopa , but have complications
Do not have significant memory or mood changes
Are generally in good health
Have Parkinson ’ s for at least four years DBS is FDA-approved for people who have had a PD diagnosis for at least four years . Beyond this , there are no hard and fast rules because everyone ’ s symptoms and course are different . But there are indicators that may point to the right “ window ” for DBS . A person may be a good candidate , for example , when they have a good response to levodopa and are still physically active , but they have trouble with how long medications work or with dyskinesia . Many
Researchers wonder whether DBS may be beneficial earlier in PD , before complications arise . Small studies suggest that DBS may lessen symptoms and medication needs in people who ’ ve had Parkinson ’ s for less than four years . Larger , longer , controlled trials will help fully evaluate potential benefits and safety of earlier DBS .