Deep Brain Stimulation

Who is a candidate for STN stimulation?

• Patients with Parkinson's Disease (PD) exhibit a number of disabling abnormalities of movement, including tremor, rigidity, bradykinesia (slowness of movement), freezing episodes, gait difficulti, and postural instability. When patients are diagnosed with PD, they are usually treated initially with a number of different medications in an attempt to control some or all of the symptoms listed above. One of the most commonly used medications is levodopa (Sinemet) - which can partially replace the neurotransmitter known as dopamine - an essential chemical in the brain which is deficient in Parkinsons's disease.
• Many of these medications are quite effective in treating these symptoms; however, occasionally, the medications lose their effectivemess, or have untoward side effects such as severe dyskinesias (abnormal movements). Additionally, patients can suffer from severe on/off motor fluctuations over time. Since Parkinson's is a progressive disease, medications which may have been effective for quite a long period of time may become less effective as the disease progresses. Patients with significant disability despite optimization of their medical regimen are candidates for STN surgery. Unlike thalamic stimulation for tremor, bilateral STN stimulation addresses all the cardinal manifestations of Parkinson's disease including tremor, bradykinesia, rigidity, gait, and drug-induced dyskinesias.
• If tremor is your only disabling symptom, both thalamic stimulation and subthalamic nucleus stimulation are surgical options. Your neurologist and neurosurgeon will help you decide which procedure is appropriate.