Is DBS a last resort treatment for Parkinson’s?
Definitely not. The window of opportunity for DBS therapy opens when a person with Parkinson’s isn’t responding to medication as well as they used to, but before the medicine stops working completely. If a person waits too long, the window will close and DBS therapy will not be able to help as much as it could have had the patient received the therapy sooner.
More than 150,000 people worldwide have received DBS therapy. It’s been helping people for more than 30 years.
How effective is DBS therapy?
85–89% of people with Parkinson's have clinically meaningful and significant improvement with Medtronic DBS.1
DBS therapy extends the control you already get from your medication for movement symptoms of Parkinson’s disease. It’s very important to mention that the success of Medtronic DBS depends on:
Based on studies comparing DBS to best medical therapy (BMT) in both early and advanced Parkinson's disease, evaluating overall motor function, the following has been demonstrated regarding the success rate of DBS:
How long will it take for DBS therapy to work after the implant procedure?
Typically, a DBS system is not activated until a patient is healed from the surgery. Once activated, troubling symptoms may decrease. Optimal results are usually achieved after multiple programming sessions with a doctor or nurse.
Can people resume their normal daily activities?
For the first few weeks after surgery, patients who have received DBS should avoid strenuous activity, arm movements over the shoulder and excessive stretching of the neck. Patients should talk with their doctors about gradually trying activities that were difficult before surgery.
Will I be able to increase or decrease the strength of stimulation?
In most cases, only the doctor can change the strength of stimulation. Depending on the system and a patient’s therapy needs, the doctor may prescribe a handheld patient programmer that allows a patient to choose from a range of stimulation settings that the doctor has preprogrammed.
Could DBS therapy cause damage to brain tissue?
One of the great advantages of DBS therapy compared with earlier surgical procedures is that the nerve tissues in the brain are not damaged by the electrical stimulus. Instead, the stimulus stops or reduces the electrical signals produced by the brain that cause the symptoms of Parkinson’s. In addition, the therapy can be reversed at any time.
Is it safe to have medical tests with a DBS system implanted?
Consult your doctor before engaging in any medical treatment or diagnostic tests, including MRI scan, mammogram, electrocauterisation and heart defibrillation. Diathermy (deep heat treatment) should never be used with an implanted DBS system.
Will I be able to have an MRI scan with a DBS system?
Seven out of ten patients eligible for DBS therapy may need an MRI following their implant.* Only Medtronic offers DBS systems that are CE approved for MRI full-body scans under specific conditions of use.
* Based on recommendations by European and national medical societies. Analyses based on PD comorbidities recommended for MRI in Europe, the % was calculated for a real-life PD population potentially eligible for DBS, from US commercial health insurance database (Conroy et al, conference presentation, ECR 2015, Vienna).
Medtronic supplemental analysis: supplement to EPDA website update re patient barriers and claims-v17-Sept-2015
The 'gold standard' of evaluating the success rate of DBS is based on the overall motor function evaluation using the UPDRS III scale. The scientifically accepted method for evaluation of the MCIC (minimally clinically important change) is at least 5 points in the UPDRS III scale. The evaluation of 'off medication' allows reflection of the impact of DBS, albeit an artificially created 'off' condition. It has not been typically reported in the publications, but we have completed the above additional analyses of the databases available in both the published evidence (only randomised control trials have been considered for this). The above analysis works for Medtronic devices only.
Scelzo E, Mehrkens JH, Bötzel K, Krack P, Mendes A et al. Deep brain stimulation during pregnancy and delivery: experience from a series of “DBS babies”. Front Neurol. 2015 Sep 1;6:191.