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Deep Brain Stimulation and Parkinson’ s
How and How Long DBS Works
Exactly how DBS works is unknown. Experts believe it interrupts abnormal brain cell signals. These signals are how cells talk to each other and how the brain directs movement, regulates mood and drives other parts of daily life. In Parkinson’ s disease, brain signals become irregular and uncoordinated, causing motor symptoms. DBS introduces a more regular signal in the form of electrical pulses, and this lessens motor symptoms.
Some people who’ ve had DBS say it seems to“ turn back the clock.” Those benefits— especially less tremor, stiffness, slowness or dyskinesia— can last for years or even decades.
But like all Parkinson’ s therapies, DBS is not a cure. It does not slow disease progression. With time, new symptoms, such as imbalance or cognitive problems, may appear. These, unfortunately, do not respond to DBS and might make DBS feel less effective. These symptoms also may require medication adjustment or addition of other treatments, such as physical or speech therapy.
Available DBS Devices
Currently, there are several FDA-approved DBS devices available from three different manufacturers. What these devices have in common:
+ Benefit Each works as well as the others. While they haven’ t been directly compared, they are all equally effective.
+ Basic components and mechanisms This includes brain leads, connecting wires and a battery.
+ Battery options They all offer both rechargeable and nonrechargeable batteries. Rechargeable batteries typically last longer. Across DBS devices, rechargeable batteries vary in how they charge( wirelessly or plugged in), equipment required to charge, and how often and for how long they have to charge.
Through The Michael J. Fox Foundation-supported RAD-PD DBS Registry, researchers are collecting and examining data about people who undergo DBS— when, for what symptoms, with which device, in what part of the brain and more. Following individuals over time will deepen understanding of the best DBS timing, lead placement and procedures and, ultimately, better guide clinicians and patients in pursuing this therapy.
+ Brain wire capabilities All brain leads allow the programming clinician to guide electrical stimulation toward areas that improve symptoms and away from areas that cause side effects. This is called“ directional stimulation.”
At the same time, each device is unique. They have slight variations, such as wires that can deliver stimulation in novel ways or record brain signals, or devices that can be programmed remotely, while you and your clinician are in separate locations. These subtle differences, how much you wish to interact with DBS by adjusting settings at home, and the surgeon and programmer preference may lead you and your team to pick one device over another.