Deep Brain Stimulation and Focused Ultrasound for Movement Disorders

What is Parkinson’s Disease?

Parkinson’s disease is a progressive, chronic neurological condition. The cardinal symptoms include:

• Tremor
• Rigidity (stiffness)
• Bradykinesia (slowness)

The symptoms result from the deterioration of a small group of cells in the brain, called the substantia nigra. This gradual deterioration also causes a decrease of dopamine, a neurotransmitter that nerves use to send signals to your body from your brain. The disruption in dopamine levels results in the physical symptoms of the disease.

How experienced is the Barrow team in treating Parkinson’s Disease patients with DBS?

We’ve been performing deep brain stimulation (DBS) for as long as it’s been available. Patients from around the country come to see us for this specific condition. 

Good outcomes rely on:

1.) Patient selection

2.) Safe and accurate surgery

3.) Optimal programming of the neurostimulator.

Our partner neurologists are experts at incorporating this therapy to optimize their care of patients with Parkinson’s Disease.  

For Parkinson’s patients, when is DBS appropriate?
Good candidates include patients who have been diagnosed with Parkinson’s for at least four years, and have had motor complications of medical therapy (i.e., motor fluctuations, dyskinesias, refractory tremor) for at least four months.  Candidacy needs to be validated by a neurologist who is a specialist in movement disorders.

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What is essential tremor?

Essential tremor is as neurological disorder that causes uncontrollable shaking, usually in the hands, but it can also affect the head and voice. Symptoms often start gradually, but can quickly worsen over time. While it’s not a dangerous disease, symptoms can become severe and negatively impact the ability to perform simple, everyday tasks.

How experienced is the Barrow team in treating essential tremor patients with DBS?
We’re one of the highest volume centers in the world when it comes to performing DBS for essential tremor. The benefits are remarkable, and are seen soon after surgery. Most patients are able to discontinue taking medicines for essential tremor.

For essential tremor patients, when is DBS appropriate?

Patients who have been diagnosed with essential tremor, who have failed medical therapy can be considered for DBS.

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What is primary dystonia?

Primary dystonia is characterized by involuntary muscle contractions or spasms. Affected areas of the body experience repetitive contractions and twisting movements, often accompanied by pain. This can negatively affect your ability to perform even simple day-to-day tasks. Dystonia can occur in a single muscle, a muscle group or in muscles throughout the entire body.

How experienced is the Barrow team in treating primary dystonia patients with DBS?

We’re one of the leading DBS practitioners in the world. We commonly see primary dystonia patients as part of our program.

For primary dystonia patients, when is DBS appropriate?

Our partner neurologists are experts at managing dystonia with pharmaceutical or nonsurgical means, such as botox. When these strategies fail, we review whether DBS in an option at our bi-monthly, multi-disciplinary, consensus conference.

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What is deep brain stimulation (DBS)?
Deep brain stimulation (DBS) therapy is an FDA-approved surgical treatment for Parkinson’s disease, essential tremor, and epilepsy.

DBS involves the placement of electrodes into brain tissue. These electrodes are connected to a medical device similar to a heart pacemaker, surgically implanted under the skin of the chest. Once activated by your neurologist, the “brain pacemaker” then sends small electrical pulses to the electrodes, helping the brain improve motor function.

What is “asleep DBS”?
DBS originally required patients to be awake for surgery. Barrow neurosurgeons were leaders in the development of Asleep DBS, which was recently FDA-approved as a safe and effective method of performing DBS with patients under general anesthesia. By removing the “fear factor” of awake brain surgery, this advance has made DBS therapy accessible to more
individuals who stand to benefit.

How experienced is the team with deep brain stimulation?
Barrow Brain and Spine is the highest volume DBS center in the country, and our extensive experience is evidenced by better patient outcomes.

What is the estimated recovery time?
Patients are typically released after an overnight stay. You’ll likely have restrictions after discharge to help expedite the healing process. Expect six weeks to recover, though most patients heal sooner. Post-operative programming of the neurostimulator occurs with the neurologist.

Learn more here:
https://youtu.be/IRslSkL5LhQ

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What is focused ultrasound?
Focused ultrasound (FUS) is a procedure that uses sound waves for therapeutic purposes. The most common application is to create a “thalamotomy “for the treatment of movement disorders such as Essential Tremor and Tremor Predominant Parkinson’s Disease.

What is a thalamotomy??
The thalamus is a central structure in the brain that relays motor and sensory information to other parts of the brain. A thalamotomy refers to an ablation of a part of the thalamus. Thalamotomies have been performed using various techniques for over 50 years to treat essential tremor and parkinsonian tremor. Focused ultrasound is an incisionless technology used to perform a thalamotomy.

How does focused ultrasound work?
Similar to how a magnifying glass can focus beams of light on a single point to create heat, ultrasound waves from around 1000 sources are concentrated to heat a small area of tissue in a precise and controlled manner. The procedure takes place in an MRI, which is used to image the brain and monitor the temperature.

How experienced is the team with focused ultrasound?
Neurosurgeons at Barrow Brain and Spine are the first to offer focused ultrasound in Arizona.

What is the estimated recovery time?
Patients are at the hospital for two to three hours. Because there are no cuts to your body and you don’t need anesthesia, you’ll be able to go home immediately after your procedure. Imbalance is common for a up to a couple of weeks following the procedure.

Learn more here:
https://youtu.be/O5LQrendNT8?si=Qi7DpITB9Qs085W-

Before and After Videos from our team:
https://www.youtube.com/playlist?list=PL6APLyFb-yLDzoOUzaRD2Rr45hH7BbunF

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