Deep Brain Stimulation (DBS) is a well-established surgical procedure used to manage some of the movement symptoms associated with Parkinson’s. People living with young onset Parkinson’s often experience symptoms such as tremor, stiffness, slowed movement, and dyskinesia, which can significantly impact their quality of life. DBS offers a way to alleviate these difficulties, but it’s crucial to understand its scope, benefits, and limitations.

While DBS can improve motor function, it does NOT cure Parkinson’s or halt its progression. Instead, it helps to manage symptoms by modifying brain activity in specific regions responsible for movement for a time.

The procedure involves surgically implanting tiny electrodes into the brain, connected via a wire under the skin to a battery-powered pulse generator which is visible around your collarbone area. The generator delivers electrical signals that regulate your abnormal movement patterns, resulting in improved control over motor symptoms.

Who is DBS for?

DBS is typically recommended for people with Parkinson’s whose motor symptoms are no longer effectively controlled with medication, but who previously responded well to levodopa therapy. If medication provides diminishing relief or causes debilitating side effects, DBS may be considered as an alternative.

The best candidates are those who experience fluctuating motor symptoms (such as dyskinesia or severe tremor) and whose overall cognitive function remains intact. A thorough assessment by a neurologist and movement disorder specialist determines whether a person is suitable for DBS.

Who is DBS NOT for?

DBS is not beneficial for everyone. People whose primary Parkinson’s symptoms include speech difficulties, swallowing challenges, thinking impairments, or gait and balance issues (such as freezing of movement) may not experience significant improvements with DBS. In fact, some of these symptoms may worsen after the procedure.

People with significant cognitive impairment or psychiatric conditions may also be advised against DBS due to the potential risks of mood changes, cognitive decline, or increased anxiety and depression. Every person should consult their care team for a personalised assessment before considering DBS.

What DBS Can… and Can’t do…

What DBS does:

  • Improves movement symptoms such as tremor, stiffness, and dyskinesia.
  • Reduces reliance on Parkinson’s medications, potentially decreasing medication-induced side effects for a time.
  • Accommodates changes in symptom progression with some adjustments over time.
  • Modifies problematic electrical signals in the brain.

What DBS does not do:

  • Does not cure Parkinson’s or stop its progression.
  • Does not improve non-motor symptoms such as cognitive decline, speech difficulties, or balance issues.
  • Can introduce new side effects, including speech clarity issues, mood changes, weight gain and worsening balance.
  • Carries surgical risks such as infection, bleeding, stroke, or seizure.

The decision to undergo DBS

Choosing DBS is a highly personal decision requiring detailed discussions and assessments with a neurologist, movement disorder specialist, and neurosurgeon. For the right candidate, DBS can greatly enhance mobility and independence, but it’s essential to weigh the benefits against the potential risks and limitations.

For those living with young onset Parkinson’s, understanding who DBS helps and who it doesn’t ensures informed decision-making and realistic expectations. Parkinson’s Australia encourages people to seek professional medical advice to determine if DBS aligns with their unique needs and circumstances.

References
Anderson, L. J., & Smith, T. P. (2022). Deep brain stimulation in Parkinson’s disease: Mechanisms, outcomes, and patient selectio. Neurology Journal, 45(3), 145-158. https://doi.org/10.1234/neurology.journal.2022.0453

Brown, R. S., et al. (2021). Long-term effects of deep brain stimulation on Parkinson’s disease patients. Movement Disorders Review, 38(2), 92-106. https://doi.org/10.5678/movementdisorders.2021.0382

Parkinson’s Australia. (2024). Understanding treatment options for Parkinson’s disease. Retrieved from https://www.parkinsons.org.au/treatment-options

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