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Benefits of Deep Brain Stimulation Treatment For Parkinson’s Disease

 When you decide to undergo DBS surgery, the first question that comes to mind that what are the benefits of Deep Brain Stimulation Treatment for Parkinson’s disease. Is Deep Brain Stimulation surgery going to change my lifestyle?

Answer: Yes.

Hopefully, you are familiar with the term DBS surgery. Many of us are thinking that what is DBS?

 If you don’t know then let me say that DBS stands for Deep Brain Stimulation.

DBS is an elective surgical process that involves implanting electrodes into certain brain areas. In the brain, which delivers electrical impulses that control abnormal brain activity.

The best part of this stimulation system is that you can adjust to chemical imbalances in the brain. Let me give you a basic idea of Deep Brain Stimulation.

Let me tell you about the benefits of DBS Surgery.

Best Benefit of DBS surgery to treat the symptoms of movement in Parkinson’s Disease:

DBS treats most of the movement-related symptoms, e.g. Tremors, Rigidity (Stiffness), slowness, etc. associated with PD

Patients with Advanced Parkinson’s disease start suffering from all the above symptoms that affect their quality of daily living.

Many patients complain of change in handwriting, unable to sign, perform fine motor tasks, and requiring assistance to do some of the daily activities.

Some of the patients complain that they are not able to enjoy their life completely, as they would wish to, e.g. someone would like to do a Social Service, someone may want to play golf, others may want to go out and meet friends, all these activities are significantly impaired as the disease progresses.

Most of the time the medical treatment offers good relief however as the disease progresses this relief is short-lived and irregular.

Patients find that the medicines are not effective all the time and every time. Patients also feel that the medical effect cannot be sustained for a prolonged period and hence they become scared about venturing out on their own.

They start becoming dependent and start isolating themselves from society. This has a negative effect on the psychology of the patient making the patient more and more depressed. This cycle has to be brain broken. 

Deep Brain stimulation surgery is the best option to break the cycle as it restores most of the functions of patients that are disabled because of Parkinson’s disease and also gives them a smooth quality of on period.

More than 90% of people with Parkinson’s have reported significant clinical benefits after DBS.

We have more than 520 DBS surgical patients operated at our center and we are proud to state that each and every patient has confirmed satisfactory benefit after DBS.

 A successful DBS journey depends on three parameters.

A) Good candidate selection for DBS surgery by the doctor. Make sure that DBS is not for everybody.

B) Best surgical placement of the DBS electrodes in the brain.

C) Knowledge about postoperative programming of the pacemaker.

Good Body Movement without Dyskinesia:

Dyskinesias are an involuntary movement which is manifested in patients of advanced Parkinson’s disease and are mainly due to the side effect of LEVODOPA treatment.

Initially, they are minimal and unnoticeable, however, as the disease progress is and the need for the metastases increases this becomes more pronounced and disabling.

DBS is one of the most effective methods of controlling dyskinesias. Patients have a 90% reduction in dyskinesias after DBS.

The reason for this is 2 fold. What is the reduction of medication by 40%-50% that we achieve after DBS therapy and second the direct effect of DBS stimulation therapy on reducing the dyskinesias?

Control of Tremors & Rigidity: 

Just imagine that you all are sitting for breakfast at the dining table. Every one of the family members is drinking a cup of coffee.

Your near dear (PD person) is trying to sip a coffee, but instead of sipping, it fells over his dress. Your natural instinct is of going and helping them, but unfortunately, PD patients have a lot of self-respect and you this gesture itself hurts them. 

Many patients, especially women, find tremors socially embarrassing. Though tremor may not be a functional handicap the presence of tremors at rest disturbs the psychology of the patient and make them very uncomfortable to be in unfamiliar social surroundings.

Tremor can be a handicap for high-performing professionals as it may be interpreted as a sign of nervousness.

All this affects the functioning and the quality of life of a person and hence any therapy that can relieve them will add a large value to the improvement of their quality of life.

Deep Brain stimulation therapy is very effective in controlling the symptom of tremors.

Good Control Of Motor Fluctuations:

Being a caregiver of Parkinson’s person, you are well-versed with these two terms such as dyskinesia & fluctuations in “ON” and “OFF” time.

DBS is known to reduce the frequency and the severity of these motor fluctuations.

Another best part of DBS therapy, it controls drug consumption up to 37% to 61%. It gives such pleasure relief to Parkinson’s people.

Benefit for Sleep and Appetite

Many patients who have undergone DBS have expressed that after surgery, they are able to sleep better.

The reason for this is that the severity of the OFF period reduces and the patient is having more comfort whilst sleeping.

The overall well-being and the direct stimulation effect of DBS also help in appetite improvement and most patients put on weight after surgery!

Improves Daily Activities for Living of Parkinson’s People:

 

All the above improvements in various symptoms of patients of PD translate into improvement in activities of daily living. , activities of daily living like dressing drinking Forte breathing, and moving around the house significantly improved after DBS surgery this once again provides much-required self-esteem to the patient.

It also eases off a lot of burdens from the caregiver.

 

Advanced Parkinson’s disease patients are known to take several doses of medication and multiple medications.

This itself is a big handicap as they start leaving within the disease and every hour or 2 hours they are reminded of taking medication which makes it difficult for them to feel normal.

After DBS, as there is a significant reduction in the amount of medication required for managing the disease, this becomes much easier. Overall wellbeing also helps in improving the general psychology of the patient.

Reduced number of medication and reduced frequency of medication is also of great help for the caregiver who may be able to find some free time for himself.

Improves Quality of Life of Parkinson’s people:

I hope that you have gone through this line, you must have got one line in your mind that all above mention benefits are leading to give good quality of life.

Improved quality of life includes other aspects as well as, such as emotional well-being, better social life, having less physical discomfort.

I guess that Parkinson’s people caregivers are looking for all these qualities in the PD people.

Less Consumption of Daily High Dose Medicine:

Hopefully, caregivers of people know that PD people need to take different doses of medicine to control the symptoms of Parkinson’s.

Initially, Pd people don’t face many side effects of the medicine. After certain years, they get severe side-effects of medication. After DBS surgery quantity of medicine will be reduced.

The biggest issue that keeping track of multiple medicines can be difficult. DBS therapy helps to reduce the amount of medication.

Very Adjustable as Per The Situation: 

The electrical stimulation of Deep Brain Stimulation can be changed as Symptoms of Parkinson’s signs of progress.

No further surgery is required to make any sort of adjustment.

DBS Stimulation settings can be updated to diminish potential side effects and improve effectiveness over time.

We will explain this in more detail in another blog.

The Device Works for 24 Hours

DBS Therapy works 24 hours a day with nominal maintenance. DBS therapy does not require removal at night, cleaning, refilling, etc.

This provides stimulation equally at any time.

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Final Point for Benefits of Deep Brain Stimulation Treatment For Parkinson’s Disease

To conclude _____ let me summarise the benefits of DBS. Deep Brain Stimulation therapy done at the right time in the right patient can offer significant control of the motor symptoms of patients with Parkinson’s disease.

Motor symptoms are the major handicap as the disease advances and improvement in this symptom translates into significantly improved quality of life.

Activities of daily living significantly improved, medications reduce, general wellbeing improves along sleep and appetite.

Deep Brain stimulation surgery should be only done at an experienced center as it is something that requires a high level of surgical expertise, understanding of the disease, and the ability to do effective postoperative management and programming.

 

For the caregiver the return of the self-esteem, the smile on the face, and the knowledge that their near and dear is now independent; can be the most satisfying and gratifying experience.

Above all, when you see the smile on their face, it touches your heart. Your near dear is an Independent person.

Let’s Hear from Our DBS Candidate

I am a doctor residing in Dubai and writing on behalf of my husband, Anilkumar who is suffering from Parkinson’s disease for last 18 years. He is a marine engineer working in a senior managerial position in Dubai. He was on increasing doses of Syndopa for last 15 years under guidance of some of excellent Neurologists. But for last 5 to 6 years the on-period after medications were unpredictable and short-lived. There was increased difficulty in walking, severe generalized tremors and stiffness making it very difficult doing daily personal and official tasks. He was very active in sports and enjoyed traveling but had to avoid all these activities. Our Neurologist in Dubai, Dr.Derk Kreiger, advised DBS surgery at the earliest to improve quality of life and recommended Dr.Paresh Doshi as one of the best in world for the same. We had been advised for DBS before also, but the doctors we met for it were not convincing enough for us to take the final decision. When we met Dr.Doshi one year back, he explained to us the procedure and outcomes, factually and in practical terms which gave us enough confidence to go ahead for the surgery. Surgery had to be kept in hold for one year due to unfortunate pandemic of Covid. The team contacted us once the circumstances were conducive for surgery.Dr.Doshi reviewed the medical status over a video consultation and surgery was planned for January 2021 and was very supportive in getting all travel clearances required due to covid scenario both in UAE and India. All members of his team especially Mr.Pankaj were very prompt and supportive in getting all the papers and arrangements done for the travel. We are very touched and appreciate the efforts done by the team in getting Mumbai airport clearance for exception for compulsory institutional quarantine which was imposed just before our travel. Hospital arranged for quarantine within their facility for both of us and convenience and services provided by administrative and nursing staff were exceptional. Dr.Doshi was very confident and reassuring about the procedure and expected outcome for my husband and was very open with all the updates throughout the hospital stay. He was very accommodative and did multiple programming sessions till optimal results were achieved. Ms.Bharati, is an asset to Dr.Doshi team. She is sincere, attentive, freely approachable and cheerful. She was always supportive and was an important factor in boosting the confidence of both my husband and I prior, during and post-surgery periods. We thank each and every member of the team and nursing and administrative staff who under guidance of Dr.Paresh Doshi, made the whole process of international travel, surgery and hospital stay easy and safe during this very difficult period of Covid even though we were strangers to Mumbai. We agree with Dr.Kreiger’s opinion about Dr.Paresh Doshi as one of the best in the world for DBS surgery. Currently my husband is rediscovering the physically active life which he had to let go for years, only because of skill and expertise of Dr.Paresh Doshi. Thank you Doc.