Behind the Scenes Extra: Q&A with Dr. Duker on Deep Brain Stimulation

Andrew Duker, MD, associate professor of Neurology and Rehabilitation Medicine at the University of Cincinnati College of Medicine, Parkinson’s disease subspecialist at the UC Gardner Neuroscience Institute and UC Health neurologist, gives insight into what deep brain stimulation is and how it can drastically improve the lives of patients with Parkinson’s disease.

 

Q: What is deep brain stimulation? How common is the procedure?

A: Deep brain stimulation (DBS) is a surgical procedure that delivers electrical stimulation to dysfunctional circuits in the brain in order to improve motor symptoms of Parkinson’s disease. It is an FDA-approved procedure that has been in use since the 1990s for the treatment of Parkinson’s disease with motor fluctuations.

Q: How does deep brain stimulation help patients with Parkinson’s disease?

A: DBS helps to reduce the motor fluctuations of Parkinson’s disease. In other words, it helps reduce the amount of “off” time a patient experiences due to the shortened duration of benefit from the oral medications. The benefit of DBS does not generally exceed the benefit of medication; however, since the DBS is on continuously, the fluctuations between off and on due to the medication wearing off are greatly reduced. In addition, DBS helps to reduce dyskinesia, a side effect of Parkinson’s medication that involves involuntary wiggling movements.

Q: What makes having deep brain stimulation surgery at UC Health different compared to other healthcare systems?

A: Here at the UC Gardner Neuroscience Institute, we have a multidisciplinary team of professionals who are experts in Parkinson’s care and in the surgical treatment of Parkinson’s disease. Our team includes fellowship-trained neurologists, neurosurgeons, neuropsychologists, nurse practitioners, nurse navigators and an excellent clinic staff. We perform thorough evaluations of all patients who are considering surgery, so we can  recommend if they would be a good candidate for the procedure. Our team has decades of experience in the use of DBS to treat Parkinson’s disease.

Q: Are there any side effects from DBS for Parkinson’s patients?

A: Side effects can occur when nearby unintended brain circuits or structures are stimulated by the DBS symptoms. The risk of this is limited by the very careful placement and testing of the electrode in the operating room. The benefit of DBS over other surgical procedures that place a lesion in the brain is that the electrical field is adjustable after the fact, the current can be increased, decreased and directed to the area of the brain with the greatest effect.

Q: In your opinion, how does having DBS provide hope to patients living with Parkinson’s?

A: DBS is a treatment that can dramatically improve quality of life for patients who are experiencing motor fluctuations due to their Parkinson’s disease. It is not a cure for the disease, but can significantly help reduce the symptoms and allow patients to live more normal lives.

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