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Sunday, April 20, 2014
Deep Brain Stimulation
What has been your experience, if any with DBS surgery with regard to how long it takes to get the setting right?
There is more than one kind of DBS. The first kind is where the electrode is inserted into the thalamus. This helps control tremor. The other two sites are the globus pallidus and the subthalamic nucleus. These are more helpful in controlling other symptoms. In my experience, it is much easier to program a DBS inserted in the thalamus for tremor control. It usually does not take more than one or two visits, each a week apart to do so. With stimulators in the other sites there are complex interactions between stimulator settings and symptom control. Medication also has to be readjusted side-by-side with changing stimulator settings. For example, with STN stimulators the dose of levodopa may be lowered by 30-70% in some cases. At our center we usually take 3-8 weekly visits before we are satisfied that symptom control is optimal with the latter two types of DBS.
Arif Dalvi, MD
College of Medicine
University of Cincinnati