OVER 800 DBS PROCEDURES ANNUALLY
SpecialtyCare’s Deep Brain Stimulation Service (DBS)
SpecialtyCare is an industry leader in deep brain stimulation, an established practice for treating movement disorders. We participate in more than 800 procedures every year, providing expertise to our partners in microelectrode recording and stimulation mapping techniques. Our neurophysiologists receive the best in training through our DBS program and through hands-on experience at some of the most respected DBS centers and top-tier DBS hospitals.
What is Deep Brain Stimulation or DBS?
Deep brain stimulation is a neurosurgical procedure used for the medical treatment of numerous neurological conditions including Parkinson’s disease, essential tremor, obsessive compulsive-disorder and dystonia. An electrode is implanted in the brain at a specific target, depending on the patient’s condition. An internal pulse generator (IPG) is implanted below the collarbone and connected via an extension wire to the electrode. This IPG generates the electrical impulses that alleviate the patient’s symptoms.
In many circumstances, DBS is utilized for patients whose symptoms have not responded well to medications or for those whose medications no longer adequately control their symptoms. Most patients will continue taking some medication following DBS, but experience a significant reduction in their symptoms.
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What Happens During DBS Surgery
An MRI scan prior to brain surgery allows doctors to identify the appropriate location for implanting the electrode. Local anesthesia is used to numb the scalp, a small burrhole is made in the skull, and thin wires are placed into the brain to further “map” or identify the intended target. This is called microelectrode recording. Once the target is localized, the permanent electrode is implanted into the brain within the target region. Patients are awake during this mapping part of the procedure to ensure that the desired impact is obtained. After the electrode is secured, an internal pulse generator is implanted below the collarbone and connected to the electrode with an extension wire that passes beneath the skin from the head to the chest. This pulse generator can then be programmed to send electrical pulses to the brain via the implanted electrode.
This surgical option is well known to improve the quality of life for most movement disorder patients. It can be a welcomed relief to those whose quality of life is dramatically affected by either the disease itself or by medication side effects. Here are some of the conditions it can treat:
- Parkinson’s Disease. DBS surgery can provide important symptom relief in patients with moderate disability from Parkinson’s disease who still retain some benefit from other medications and who are considered well cognitively. Some people with severe Parkinson’s disease have symptoms that can’t be controlled by medication. Other practical methods of relieving symptoms, such as DBS, can help. The results of recent clinical trials found that DBS improves the overall quality of life and functioning of patients in the earlier stages of Parkinson’s disease.
- Dystonia. A study was conducted of people with the most common form of hereditary dystonia and it states that DBS brought lasting benefits for patients. However, it does appear to be more effective for some types of dystonia than for others, and more research is still needed to be done.
- Tremors. A team from the University of South Florida discovered that a significant number of patients were able to stop taking medications used for essential tremors within one year after surgery after a DBS procedure.
- OCD, Tourette Syndrome, and Depression. Three out of four people with obsessive-compulsive disorder benefit from treatment with DBS. People with Tourette syndrome who received treatment have found they have fewer tics after DBS, but there is some evidence that people with this condition may be at higher risk of complications following the procedure. This also includes psychological effects.
Deep Brain Stimulation (DBS) Research
Research on patients in Canada has shown that those with major depression showing resistance to other types of treatment, experienced positive results after treatment with DBS. Research has suggested that DBS could be useful for treating depression, but scientists also urge caution in using such treatment for patients with advanced psychiatric needs.
Some neurosurgeons have suggested that DBS could help some people with alcohol addiction by impacting the “addiction circuitry” of the brain. But more studies are recommended on the effect DBS has on eating patterns.
According to doctors, the time to consider deep brain stimulation surgery is when the quality of life is no longer acceptable by the patient after consulting with a movement disorders neurologist. But like any procedure, there are risks associated. There is a one percent risk of stroke causing permanent damage due to bleeding in the brain, and a two-to-five percent chance of infection. DBS is a therapy that requires regular neurological follow-up and battery changes every three-to-four years.
What SpecialtyCare Deep Brain Stimulation (DBS) Provides
Our clinical experience with DBS and continuing training allows us to provide you with a reliable interpretation of microelectrode and stimulation mapping results. Surgeons appreciate that our highly customized and efficient mapping protocol does not add significant surgical time. Contact us to learn how we can provide any combination of the following services for your hospital:
- Specialized capital equipment necessary for subcortical brain mapping, including microelectrode recording and microdrive systems from FHC.
- Assistance with surgical planning
- Set up, operate, and troubleshooting of neurophysiology system
- Operation of microdrives that advance microelectrodes (surgeon does not need to scrub out)
- Identification of location of neurons responsive to kinesthetic, tactile, or visual stimulation
- Assistance in identification of stimulation-induced treatment efficacy and side effects
- Technical summary and interpretation of MER and stimulation results to help surgeon identify optimal location to implant the DBS lead
- Upon request, consultation on technical issues related to the DBS procedure
- Didactic support for OR staff, residents, and visitors regarding the theory and practice of DBS
- Scientific support for ongoing research projects
DBS Treatment Through SpecialtyCare
Hospitals and surgeons all over the United States rely on our highly experienced, PhD-trained DBS specialists. By performing one in every eight deep brain stimulation procedures in the U.S. (over 800 procedures each year) our DBS team leads the market within the industry and provides unmatched expertise in microelectrode recording and stimulation mapping techniques to improve overall patient outcomes while decreasing the number of stimulation-induced side effects. Our extensive experience and specialized training in DBS mapping protocols and DBS equipment, such as stereotactic, neurophysiology, and microdrive systems, ensure that your surgeons receive the best guidance available without adding significant surgical time.
Deep brain stimulation therapy is approved by the U.S. Food and Drug Administration (FDA) to treat the symptoms of neurological disorders, such as Parkinson’s disease, essential tremor, dystonia, and obsessive-compulsive disorder. DBS is also being explored as a treatment for several other disorders, including Tourette syndrome, epilepsy, and neuropathic pain. During the DBS implantation surgery, an electrode is placed in the brain to regulate abnormal electrical activity. Our neurophysiologists assist the surgeon by performing DBS mapping to identify the best location to place the electrode. Again, the procedure is done while you are awake. We monitor the activity of the brain cells, and conduct test stimulation prior to the placement of the permanent electrode. With DBS mapping, your surgeon is able to find the spot that will be most effective at reducing your symptoms while limiting potential side effects.
Let SpecialtyCare’s Deep Brain Stimulation (DBS) Team Help
Our approach to deep brain stimulation (DBS) is based on the belief that a combination of clinical excellence, compliance, and dedicated personal service is needed to ensure the very best in patient care and cost management. At SpecialtyCare, our goal is to help you build a surgical team and operating room of excellence and to provide the best outcomes. Patient care and support will always be our first and last priority.