Every year, approximately 60,000 people are diagnosed with Parkinson’s disease. In addition, about 10 million people in the United States have essential tremor—a neurological condition that causes a person’s hands, head, or voice to shake. These conditions can seriously affect a person’s quality of life, preventing them from being able to dress or feed themselves or drive. At the same time, medications can have side effects and tend to lose effectiveness over time.
If this describes you or a loved one, new technology called deep brain stimulation(DBS) could offer an alternative. The procedure was discovered in 1987 by a French neurosurgeon named Alim Louis Benabid when he was preparing to remove a part of the brain. He used a common technique to send electrical pulses into the brain in order to activate the part of the brain he wanted to remove and confirm that it didn’t perform a crucial function. For reasons we don’t know anymore, Dr. Benabid used twice as much electricity as he should have, and in so doing made a groundbreaking discovery—the surge of electricity halted the tremor that had plagued the patient for years.
Dr. Benabid’s discovery that electricity can change nerve activity became an FDA-approved treatment for Parkinson’s and essential tremor in 1997. Twenty years later, more than 100,000 people in the world have been helped by this treatment. Scientists are now looking into ways DBS can also help patients with dystonia, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), major depression,chronic pain, Tourette’s, and other neurological conditions.
Until recently, patients in the Northeast had to travel long distances to have this procedure done, but in 2012 Yale Medicine launched its Deep Brain Stimulation Program. Now performing more than 50 surgeries a year, we are one of the highest volume centers in the area.
Our DBS team is led by Jason Gerrard, MD, PhD, chief of functional neurosurgery at Yale Medicine. Dr. Gerrard is trained in both neurosurgery and neurophysiology, which allows him to both perform the surgery and test the neurons. Traditionally, a neurophysiologist will guide a neurosurgeon during the DBS surgery, but Dr. Gerrard’s expertise allows him to oversee the entire process.
We understand that surgery is a big step and want to make sure that each patient who undergoes it is a good fit. The first step for people considering DBS is a visit to a movement disorder neurologist here at Yale Medicine who will perform a comprehensive series of memory, cognitive, and neuropsychological tests. Then, our team, made up of neurosurgeons, neuropsychologists, and physical therapists, will meet to discuss the patient’s case and decide whether or not he or she is a good candidate for the procedure.
For those who do undergo DBS, the effects can be life changing: “When patients first come into our clinic, they often have tremors so severe that they are disabling. Watching them go through DBS and return to their normal lives is extremely rewarding,” says Dr. Gerrard.
Source : Yale University