Deep brain stimulation (DBS) in Parkinson’s disease is a surgical technique that has been shown to help modulate abnormal brain activity in individuals living with this condition.
What Is Parkinson’s Disease?
The exact cause of Parkinson’s disease is unknown, but it is recognized as a chronic neurodegenerative disorder that affects millions of people worldwide. It is characterized by the progressive loss of dopaminergic neurons in a region of the brain known as the substantia nigra.
These neurons produce dopamine, a neurotransmitter essential for motor control.
In Parkinson’s disease, dopaminergic neurons degenerate and die, leading to reduced dopamine levels in the brain. This lack of dopamine is the primary cause of the motor symptoms associated with Parkinson’s, including tremors, stiffness, and slowed movement.
Parkinson’s Treatment
The main goal of Parkinson’s disease treatment is to manage symptoms and improve quality of life, as there is currently no definitive cure.
Therapeutic strategies fall into three categories:
- Pharmacological treatments: These are the most common in early stages and aim to restore dopamine balance in the brain using medications.
- Non-pharmacological therapies: These are used alongside medication and include complementary approaches like physical therapy, motor rehabilitation, speech therapy, and psychological or emotional support.
- Surgical options: Several types of surgery exist for Parkinson’s. While none cure the disease, they can significantly improve symptoms in certain patients. One of the most effective is Deep Brain Stimulation (DBS).
Deep Brain Stimulation for Parkinson’s Disease
Deep brain stimulation involves implanting electrodes into specific areas of the brain that emit electrical impulses to help regulate abnormal brain activity.
In Parkinson’s disease, the motor circuit in the brain is disrupted due to the lack of dopamine, resulting in disorganized signals in areas such as the subthalamic nucleus (STN) and the internal globus pallidus (GPi).
DBS helps improve motor symptoms by continuously stimulating these areas and restoring more normal signaling patterns.
- STN Deep Brain Stimulation (DBS Target – STN): Is one of the most commonly used targets, stimulating the subthalamic nucleus and helping to improve motor symptoms such as tremor, rigidity, or bradykinesia. It also allows for a reduction in the dose of antiparkinsonian medications, which is beneficial for young patients or those with good cognitive function. Furthermore, its stimulation may increase the risk of neuropsychiatric side effects such as depression or cognitive impairment.
- GPi Deep Brain Stimulation (DBS Target – GPi): This is especially useful in patients with severe dyskinesia, involuntary and abnormal movements. Although it doesn’t reduce medication as much as STN, it offers excellent control of motor symptoms without compromising emotional stability or cognitive function, which is why it is often chosen for older patients or those with some level of cognitive impairment.
Due to its complexity, deep brain stimulation is not recommended for all patients. DBS is typically advised in cases of idiopathic Parkinson’s disease (not atypical), where symptoms were initially well-controlled with levodopa, but the patient now experiences motor fluctuations, has no significant dementia, and is in good general health to undergo surgery.
While medication remains the cornerstone of treatment, DBS has become one of the most effective options for selected cases.
At the Parkinson’s and Movement Disorders Clinic at ABC Medical Center, we can provide you with specialized care. Contact us!
Fuentes:
Boston Scientific, MedlinePlus, Scielo
