Deep Brain Stimulation

Wellness Series

Speakers: Sudeshna Bose, MD and Eric Rhoden, PT, DPT

Wellness Series Summary – Deep Brain Stimulation Q&A

Speakers: Sudeshna Bose, MD and Eric Rhoden, PT, DPT

 

What is Deep Brain Stimulation (DBS)?

  • Surgical option for the treatment of Parkinson’s disease that works like a pacemaker for the brain
  • Most effectively treats tremor but can also treat rigidity and bradykinesia especially in the periphery
  • Not effective at treating midline symptoms such as posture, balance, speech, swallowing, and constipation

What occurs during DBS surgery?

  • Leads are placed into the brain either unilaterally or bilaterally
  • The voltage is revved up during surgery and you may be asked to speak or perform movements with your hands to make sure there are no side effects

What type of preparation is needed for DBS?

  • On/off testing
    • Good candidates perform ~30% better with testing during on state versus off state
    • Those who respond well to medication typically respond well to DBS
    • Can also help determine appropriate location for placement and what kind of improvement may be expected
  • Neuropsychology/cognitive testing
  • Meeting with surgeon

What takes place after the surgery?

  • Usually requires an overnight stay
  • Battery is typically placed 1-2 weeks later
  • Approximately 1-3 weeks later, a screening is performed to determine which contacts should be stimulated for optimal programming
  • Programming can take days to weeks to months as the brain heals
  • Some programming appointments allow you to come in on your “on” state, but most ask you to come in on your “off” state

Where is the battery placed?

  • The battery is most commonly placed over the chest
  • It can also be placed in the abdomen

How and when is the battery replaced?

  • Surgical procedure that occurs every 4-6 years
  • Battery cannot guarantee voltage as it gets low and you may see symptoms return

When should someone consider DBS as a treatment option?

  • If you are a good candidate, DBS is recommended earlier rather than later for the most benefit

What are the possible negative side effects?

  • Can negatively affect cognition and speech (especially when done bilaterally)
  • Unrealistic expectations leading to disappointment

Why would DBS be performed bilaterally instead of unilaterally?

  • If PD symptoms are on both sides of the body, DBS is typically performed bilaterally
  • If PD symptoms are only on one side of the body, DBS is typically performed unilaterally
  • If PD symptoms are on both sides but minor on one side, it may be performed unilaterally

What percentage of people with DBS cannot tolerate it or need to have it removed?

  • If there is an infection, then the DBS needs to be removed
  • If the stimulation is causing side effects rather than helping, DBS may be turned off

If there is an infection and the DBS is removed, can you have it reinstalled at a later date?

  • DBS can be reinstalled, but it will need to be placed in a different tract after the infection has cleared.

Does insurance cover DBS?

Can I stop taking my PD medications with DBS?

  • Medication can usually be reduced by 30-50% with DBS but will not eliminate PD medications

How often does programming occur and why?

  • Every 3-6 months on average
  • Due to disease progression
  • To check the battery life
  • Improve current programming

Can I adjust my own programming?

  • You may be allowed to adjust your programming within certain parameters
  • Some clinics do not allow any adjustments
  • You may have different groups of programming to target different symptoms
    • A group for tremor control and another group for walking

Receive 50% off for 3 months

A Special Parkinson's Awareness Month offer

Enter AWARENESS2022 at Checkout 

Receive 50% off your subscription for 3 months.

We offer Live and On-Demand classes. We'll see you soon!

(A $75.00 to $279.00 value depending on your subscription choice)
Limited Quantity
expires April 31st, 2022  *valid for new members

More Wellness Series

Clinical Trials and PD

Clinical Trials and Parkinson Disease PWR! Wellness Series Speaker: Paul Larson, MD, FAANS Neurosurgeon, Professor May 18, 2022 4:30 – 6:00PM (AZ time) Deep Brain Stimulation is currently the gold standard surgical treatment for Parkinson’s Disease. Biological treatments such as gene therapy and cell transplantation for Parkinson’s disease have been explored in clinical trials over…

Read More

Balance and Parkinson’s with Jennifer

Ask the Parkinson’s Expert about Balance An hour to ask every question you have about balance and how it relates to Parkinson’s. Jennifer is a Parkinson’s expert. Join us! The process of balance control is complex and dysfunction can interfere with our ability to remain upright and steady. For people with Parkinson disease, the motor…

Read More

Normalize Walking with Urban Poling

Improve Balance, Enhance Movement & Normalize Walking with ACTIVATOR Poles Join us to discover why clients with Parkinson Disease describe the use of evidence-based Activator Poles as being life-changing. “ACTIVATOR Poles should be called Confidence Poles! I can say YES to being active” Learn how the ACTIVATOR PUSH Technique improves balance, posture, and increases core…

Read More

Reiki Breath and Health – Wellness Series

Reiki Breath and Health Wellness Series Speaker: Ann Baldwin, PhD February 16, 2022 4:30 – 6:00PM (AZ time) Recording is available below. Join us on Zoom for: REIKI, BREATH, AND HEALTH Join us as we learn about Reiki from Ann Baldwin, PhD and Reiki Master. She will discuss what Reiki is and: How it benefits…

Read More

Speakers

Eric_Rhoden

Eric Rhoden, PT, DPT

Dr. Eric Rhoden, PT, received his Bachelor of Science from California State University San Marcos and his Doctorate of Physical Therapy from Loma Linda University in Loma Linda, California. Eric is a certified PWR (Parkinson’s Wellness Recovery) therapist and prior LSVT BIG certified. He has specialized in the movement disorder population since 2014. He has a fitness and orthopedic background, which he has fused with his passion and knowledge for the movement disorder population to create comprehensive and individualized treatments. Dr. Rhoden educates patients on the relationship of nutrition and systemic body function. He is one of the primary deep brain stimulation programmers at Neurology Solutions Consultants for the past 5 years. He brings a unique perspective to the deep brain stimulation programming and utilized individualized assessment tools to maximize benefit.  

 

Dr. Rhoden is married with an 8 year old son. In his free time, he enjoys serving at his church, coaching his sons sport teams, cooking, outdoor activities, and competing in fitness competitions.  

DrBose

Sudeshna Bose, MD

Dr. Bose is a movement disorder specialist with over 20 years of experience in the medical field. She is also an Assistant Professor of Neurology at the University of Arizona, where she completed her residency and fellowship. Her clinical interests are in Parkinson's disease, movement disorders and ion channels.