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 .