Dr. Deborah Boland, a neurologist specializing in movement disorders at Ascension Sacred Heart in Pensacola, Florida
Ascension Sacred Heart Pensacola is now offering the most advanced technology for deep brain stimulation, a neurosurgical procedure to improve tremors and other symptoms of Parkinson's disease. The surgical team was led by Dr. Deborah Boland, a neurologist specializing in movement disorders, and Dr. Ann Carr, a neurosurgeon.
"Deep brain stimulation isn't a cure for Parkinson's but it can reduce several of the debilitating symptoms and significantly improve daily function and quality of life for many patients," Dr. Boland said. "We are pleased to bring the latest DBS technology and therapy to eligible patients across Northwest Florida."
The first surgery at Ascension Sacred Heart 's Advanced Brain and Spine Institute was performed successfully on Oct. 13. DBS delivers mild electrical impulses to a targeted area of the brain that is responsible for the movement symptoms caused by Parkinson’s disease. The electrical impulses can block or change the abnormal nerve activity that triggers symptoms.
DBS was first introduced 15 years ago and improved as new technologies were developed. It is an effective therapy for essential tremor, a movement disorder that causes people's hands or arms to shake while doing daily activities such as eating or writing. Essential tremor also may impact the head, vocal cords and tongue, and worsen stress and fatigue. DBS surgery also may improve other movement symptoms of Parkinson's disease, such as slowness of movement, stiffness or rigidity, and problems with walking and balance.
In the multi-stage procedure, electrodes are positioned in the brain and then a device that sends the electrical pulses to the electrodes is implanted under the collarbone. A thin wire is placed underneath the skin to connect the stimulator device to the electrodes.
"A critical piece of the surgery is positioning the electrodes in the precise location of the brain that is causing the tremors and other symptoms," said Dr. Carr. "CT scans or MRI scans are taken before and/or during the procedure to pinpoint the exact areas to target and guide the lead and electrode placement."
Once activated, the pulse generator sends continuous electrical pulses to the target areas in the brain. The system operates much the same way as a pacemaker for the heart.
The implanted generator is turned on by a hand-held device and the electrical pulses are adjusted until symptoms improve. Several follow-up programming visits will be needed to fine-tune the stimulation sent to the brain to best relieve symptoms.
Before being considered a candidate for the therapy, patients must undergo an extensive evaluation process. Candidates for DBS are generally patients who meet these criteria:
- Symptoms are not well controlled despite receiving the appropriate dose of medications.
- Patients who have experienced symptoms for five or more years.
- Symptoms are significantly reducing a patient’s quality of life.
- Side effects from current medications cannot be tolerated.
Unlike other surgical options, an advantage of DBS therapy is that it is reversible; the device and electrodes can be turned off or surgically removed if the therapy does not work or it produces lasting side effects.
Boland, the area's only movement disorders specialist, said the team at Ascension Sacred Heart is using innovative wireless software to make DBS therapy more convenient and personalized. The Abbott device has FDA approval for remote programming capabilities. That will allow her to change the settings on the device while the patient is in their home. This feature will save patients a long drive to her neurology office in Pensacola.
For more information, visit ascension.org/sacredheartneuro.