Neurosurgery and Brain Health Deep Brain Stimulation to Treat Parkinson’s Disease: David’s Story By Neurosurgery, June 28, 2014 David Smith did not want to let Parkinson’s disease prevent him from walking his daughter down the aisle on her wedding day. Medication was not helping with his symptoms, so a family member suggested that he try an alternate treatment: deep brain stimulation, or DBS. Parkinson’s disease is most common in people over the age of 50. Symptoms of this disorder include: Stiffness Uncontrollable or very slow movements Trouble with balance and coordination A tremor (shaking) in different parts of the body. This disorder affects the part of the brain that coordinates movement. Over time these symptoms can cause people to have difficulty doing everyday activities such as walking or talking. David’s tremors were so severe he could not stop shaking. Medications had helped him at first, but they had stopped being effective. For people like David, whose Parkinson’s disease is not well-treated with medication, deep brain stimulation may help. In DBS, a neurosurgeon implants a hair-thin wire into an area of the brain that contributes to the abnormal movements. The surgeon attaches the wire to a pulse generator that is implanted under the skin below the collarbone. Once the generator is activated, it will send electrical pulses through the wire to the brain, similar to how a pacemaker works with your heart. This can control Parkinson’s symptoms by adjusting the brain’s electrical signals. This form of treatment has shown positive results: it has lessened people’s symptoms by 40 to 60 percent. This is not a cure, but it does improve the individual’s quality of life. Deep brain stimulation can be performed one of two ways: lightly sedated but awake, or completely asleep. In awake DBS, the patient is sedated during the beginning and end of the case, but remains alert during the middle of the surgery. Images from an MRI scan, taken before the surgery, help surgeons plan the procedure. Asleep DBS uses a different approach, where the patient can be put to “sleep” under general anesthesia. Surgeons use a surgical imaging system that gives them real-time images of the brain to guide the procedure. UPMC is one of only a small number of institutions in the United States that perform asleep deep brain stimulation. David decided to undergo asleep deep brain stimulation at UPMC. Before the treatment, his symptoms were so severe that he could not sit still without shaking, and he could barely walk. Afterward, his symptoms improved so much that he was able to walk his daughter down the aisle on her wedding day — and even dance with her at the reception. Learn more about David’s experience with deep brain stimulation at UPMC.