Deep brain
stimulation (DBS) is a treatment intended for people for which other treatments
for Parkinson’s disease have not been effective. The neurostimulator is placed
into the chest similar to a pacemaker. The device is connected to the brain via
wires and blocks signals that cause involuntary motions and ameliorates
symptoms such as stiffness and tremor by supplying constant electrical impulses.
During the surgery the recipients of the device are awake (they receive a local
anesthetic). DBS was approved by the FDA for the treatment of Parkinson’s
disease in 2002. Risks for the surgery include hemorrhage or stroke, infection,
and trouble sleeping, among others. For many, the benefits of DBS outweigh the
risks
Andrew Johnson is
an individual who responds really well to DBS. He takes other treatment in
connection with the electrical impulses he receives from his device for an
enhanced benefit. He demonstrates how his device works in the video shown
below:
The
advances in technology that allow Andrew to complete daily tasks despite his
condition are amazing. Hopefully with the breakthroughs seen in heart surgery
with non-invasive procedures, there will be non-invasive brain therapies available
soon to administer these electrical impulses that improve Parkinson’s symptoms
with reduced risk.
Sources:
For more about Andrew Johnson: http://youngandshaky.com/
While working in the emergency room, I was lucky enough to meet a patient that had the deep brain stimulator and it was absolutely amazing to see the difference between it being on and off. It was like a whole new person. This is a great achievement and hopefully it will become less or non-invasive!
ReplyDeleteThat's incredible Alison! You can find quite a few of these videos online, but seeing the change this device makes in person would be really amazing.
DeleteThis is just plain out amazing. Parkinson's Disease is a disease that disables a person from fully living out their lives in the way they want to and knowing that there is now an effective treatment that can help empower these people to take control of their lives again is wonderful to hear. And reading Alison's comment above makes me really jealous. I would have loved to see the difference the treatment makes first-hand as well, haha.
ReplyDeleteSydney, I agree. I don't personally know anyone with Parkinson's disease, so when I realized that tremor is actually a really debilitating shaking and not just little shivers, I was astounded. This treatment really is life changing.
DeleteThanks for giving us a great illustration of just what Deep Brain Stimulation can do! It also reminded me just how quickly neurological changes can be observed; had he been showing us how his oral medication made a difference we would have waited minutes or hours to see the effects we saw in seconds.
ReplyDeleteThat is a great point, Jen. He had mentioned that he was off his oral medication for about a day, which does demonstrate it acts slowly. It really hits home to see the immediate effects of the device.
DeleteThat was a remarkably fast acting treatment. His symptoms were so severe I could tell he was extremely uncomfortable. I understand the initial surgery may be invasive but being able to change your life at the push of a button makes it seem practical. The devise itself also doesn’t seem to impede daily life; no one could tell he had one since its surgically inserted. I had never heard of DBS and seeing it just shows how great technological advances are and that there are more to look forward to
ReplyDeleteThanks for that comment, Jameson! It is great that no one can tell about his condition or his device because it works so well. I am glad the doctors figured out that they can place the device in the chest, because having it in the cranial area, no matter how small, I think would be uncomfortable.
DeleteI understand that there is no cure for Parkinsons but after watching the video it is absolutely remarkable to see how beneficial the deep brain stimulator is. It is an invasive surgery but when all is said and done it seams as though patients can actually live a normal life. Technology like this really is a reminder about how far we have came as a society in regard ti how well this treatment works;furthermore it provides optimism for the future for many diseases that we don't yet have a cure for. Great post, once again it is truly beneficial to see a person with Parkisons rather than reading all the symptoms on a piece of paper.
ReplyDeleteThank you for your comment, Anaiz. It is true that even though the surgery is invasive it definitely provides a great benefit and increases the quality of life for someone with Parkinson's disease. And I agree; I felt showing a video would explain more than I could in three paragraphs about the route of the probes and the impact of the device in DBS treatment.
DeleteWow thanks for posting that Marissa that video really is something amazing. At the beginning of the video he was functioning just as any normal adult but immediately after turning it off he completely changed. I have never herd of DBS before but it does seem to be a remarkable invention. Do you know if the majority of people with parkinson's are eligible for this procedure or if there are a lot of restrictions on who can receive this?
ReplyDeleteHello Dan,
DeleteThank you for your question. This is some criteria from from the link to the experimental study I provided in the blog post:
To be eligible for the study, volunteers must:
-Have Parkinson’s disease, certain types of dystonia, or essential tremor. In the case of Parkinson’s disease, the condition must improve with levodopa (Sinemet).
-Have tried medications for their movement disorder but still have severe symptoms.
-Be able to provide their own informed consent for this study.
Volunteers will be excluded if they:
-Are pregnant.
-Have dementia, depression, or another psychiatric disorder.
-Have metal in their body which would make having an MRI scan unsafe—such as pacemakers, medication pumps, aneurysm clips, metallic prostheses, shrapnel fragments, permanent eye liner or small metal fragments in the eye.
-Cannot lie comfortably on their back for up to one hour in the MRI scanner.
-Have any medical condition that would make their participation unsafe.
-Have movement disorder symptoms due to a known cause.
Some of the criteria that would exclude an individual are particular to the study (MRI). Pregnancy, though not common in people with Parkinson's, is possible because like we saw with Andrew some people are diagnosed at a young age (30s). I do not know specifically how many people are eligible for DBS, but the criteria seems to highlight again the necessity of other treatments first not being sufficient before this treatment is considered. Hope that helps!
These devices really are incredible! With the device you can't even tell that he has this disease. The difference between the device being on and off is remarkable. I didn't know the change was so instantaneous from where he turned the device off. I wonder how much it costs to have the device implanted and then how much it costs to maintain it.
ReplyDeleteHi Bonnie,
DeleteDoing a quick internet search it looks like DBS surgery costs on average between $30K-$50K, not including MRI and doctor fees. This was just from a quick search on Google, but three sites seemed to say around the same price, +/- $10K. A big investment, for sure.
Hey Marissa! Thank you for this great post, it really shows the power of medicine and modern technology! I still cannot believe that this device allows patients to live a seemingly normal life, as the gentleman in the video described. Meeting him in his day to day life, you would have no idea that he suffers from Parkinson's disease. You mentioned that this treatment is a last resort when treatments have not been effective. I wonder why this is the case, other than the high cost of the surgery and maybe possible fears of getting the surgery. It seems the effectiveness of this device would make it more widely used amongst Parkinson's patients.
ReplyDeleteHello Maddie,
DeleteI wondered also what the reason might be for DBS not being offered up front to individuals with Parkinson's disease. I think it might be due to the invasiveness of the procedure, though it is minimal. Hearts surgery isn't the first treatment suggested to people with heart disease. There are probably other factors involved, such as cost, like you had mentioned.
Hey Marissa,
ReplyDeleteWatching that video was amazing. It's incredible to see how far treatment for neurodegenerative diseases has progressed in recent times. I looked a bit more and found that that DBS is also thought to be helpful in treating OCD. There have been minimal trials so far , and this is an awfully invasive and expensive procedure to treat a condition that can be otherwise managed with relative ease, but the potential is still intriguing.
Hello Michael,
DeleteDBS is approved as a treatment for a number of conditions, including central tremor and OCD (experimentally, as you had mentioned), and is being explored as a treatment for recurring headaches. It seems to be effective for more than it was intended for. It will be interesting to discover what else it can be used for.
Good job Marissa! That video was a good find! It's natural for me to be skeptical, but the contrast was very sharp. In the latter part of the video, I was questioning whether Andrew would be able to turn his DBS device on again unassisted. One thing I like about this treatment is that it comes from a mechanistic understanding of neuron activity that lent itself to a proposed treatment that saw fruitful results. This is very affirming from a scientific approach standpoint, whereas many treatments are not understood very well in their mechanism.
ReplyDeleteThanks Abraham! The contrast is definitely astounding. I found it interesting that the treatment did not work through dopamine or receptors but instead through electrical impulses. Like you had mentioned, an understanding of how neurons and different aspects of the body work is crucial for making these treatments successful.
DeleteI enjoyed your post and the video therein, Marissa - thanks! I've included a link to another interesting video along the same lines. Here, surgeons are performing the DBS surgery while the patient is awake and playing guitar so that the surgeons can note and improvement in symptoms to indicate they are in the right area for treatment.
ReplyDeletehttps://www.youtube.com/watch?v=TB031Rv34qc
Marissa,
ReplyDeleteThis is an incredible video that you found to share. I actually think that putting this video does a lot more than citing a study as information for how it helps. After watching this, I want to research more about how specifically DBS can accomplish this. I think it is great that this is FDA approved and amazing how much it can help this man, although I'm guessing it doesn't work for everyone the same. Great job!
This video was amazing. It's amazing that people have figured out how to improve his Parkinson's significantly with this deep brain stimulation. This video showed a vivid example of his symptoms essentially disappearing when he is undergoing the electrical stimulation. If results like this are common, it seems like this is a very effective way to combat Parkinson's and definitely increases the person's quality of life exponentially.
ReplyDeleteWow, that video was pretty cool to see especially the impact the electrical impulses have. The video provides a better understanding of just how powerful that work can be, and was better than reading an article/study :). I definitely agree with you about non-invasive brain therapies, which would reduce the risk greatly and allow more people to benefit from it. Since the DBS is placed inside the chest it creates a scare for many people not wanting to undergo such a intense surgery.
ReplyDelete