8Deep Brain Stimulation and Parkinson’ s
The DBS Evaluation Process
When considering DBS for an individual, a team of health care professionals performs a thorough evaluation. This can take several months. Some people begin this process even if they are on the fence about DBS. Starting doesn’ t require you to complete testing or have DBS if you ultimately decide against it.
Your DBS team may include a:
+ Movement disorders neurologist
+ Parkinson’ s nurse, nurse practitioner or physician assistant
+ Brain surgeon( neurosurgeon)
+ Physical therapist
+ Occupational therapist
+ Speech therapist
+ Psychiatrist and / or psychologist
+ Neuropsychologist( thinking / memory expert)
+ Social worker
+ Dietitian
The DBS team assesses your:
+ Medications and therapies What Parkinson’ s treatments you’ re taking, what you’ ve tried, and benefits or side effects.
+ Brain imaging and other tests A brain MRI and / or CT scan and a detailed memory and thinking exam, administered by a neuropsychologist.
+ Motor symptoms Examinations both on and off Parkinson’ s medication to see if and how much symptoms improve, whether you have dyskinesia or dystonia, and check your walking and balance.
+ Non-motor symptoms Non-motor changes could affect or be affected by DBS. These may include mood problems, impulse control disorders( excessive spending, gambling or interest in sex), thinking and memory changes, or swallowing and speech difficulties.
+ Medical problems or concerns Medical conditions or other factors that may impact evaluation and prep, surgery or recovery, or life with the device.
+ Support system Who can support you throughout the DBS journey. This could include family members, friends or members of your faith or Parkinson’ s community. Your care team will help you build a support system if you don’ t have one in place.
+ Hopes and expectations What do you hope to gain with DBS? What would be the best outcome? Would you like less dyskinesia, tremor or dystonia? Smoother walking? Fewer pills each day? To play guitar again, travel or play with your grandkids? The more specific the better. This guides conversation around whether and how DBS may meet your goals.
Once the team gathers this information, they weigh the potential benefits and risks to make a recommendation. This could be to move forward with DBS; further discuss a specific element, like your goals or support system; order additional testing; or consider a different treatment.