What is the Deep Brain Stimulation Success rate for Parkinson’s? – Deep Brain Stimulation for Parkinson’s Disease – Drkharkar

Deep Brain Stimulation Success rate for Parkinson’s disease is excellent.

According to Medtronic’s data, 85-90% of patients have significant improvement after DBS.

DBS does not reduce all symptoms equally. It reduces some symptoms more than others.

In most cases:

  • DBS reduces the major symptoms of shaking, stiffness and slowness.
  • Patients walk faster. However, DBS does not reduce imbalance.
  • DBS reduces many non-motor symptoms of Parkinson’s disease. But it may worsen thinking problems & depression.

So, we should discuss Deep Brain Stimulation Success rate under different headings.

Please note that this is the average improvement after DBS. A few patients may not benefit. The reasons for DBS failure are also described below.

Let us begin.

Deep Brain Stimulation Success rate for Shaking, slowness and stiffness

Shaking (Tremor) responds very well to DBS. In most cases, the severity of tremor decreases by more than half (>50%).

In the future, customized DBS may reduce tremor by almost 90%. Customized DBS includes putting the wire into other targets (such as the zona inserta). Currently, we can use this data during programming to stimulate these areas as well.

Tremor e1573658344750
DBS is very successful in reducing uncontrolled shaking (Tremor).

Tremor is the most noticeable symptom of Parkinson’s. But, most patients complain that stiffness and slowness are most disabling.

DBS works great in reducing these symptoms as well. Both are reduced by more than half (>50%). Again, future customized DBS may be even more successful.

 

Deep Brain Stimulation Success rate for Walking and imbalance

As expected, patients with Parkinson’s walk slowly. They may also have episodes when they feel “stuck” to the ground. This is called “Freezing”.

After DBS, patients walk much faster. Also, “Freezing” is reduced.

walking
DBS enables patients to walk faster. Also, they get fewer episodes of feeling “stuck” to the ground (Freezing).

What is the problem?

DBS does not improve balance. In about 1/3rd of patients, it may worsen balance.

So are falls more common after DBS?

No. Most studies indicate that falls decrease after DBS. For example, Dr. Karachi reported that falls reduced in 1/3rd of patients after DBS.

You see, one of the major cause of falls is “Freezing” of gait. Reduction in “freezing” leads to a reduction in falls.

Again, this is an average. If you are falling due to instability rather than freezing, you may fall more often after DBS (see box).

If I fall often, should I get DBS?
You should discuss 3 questions with your doctor:

1. Why am I falling? Is it because of Freezing or Instability?
2. Do I have a “Parkinson’s Plus Syndrome”?
3. Is another problem (for example, B12 deficiency) causing my falls?

If instability is the cause of your falls, proceed only after understanding the pros & cons. If you have a Parkinson’s plus syndrome, consider not getting DBS.

Falling e1574089012814
If you are falling down often, you should find out the reason why you are falling BEFORE you get DBS surgery.

Deep Brain Stimulation Success rate for Non-Motor symptoms

Patients with Parkinson’s disease have non-movement problems as well. These include sleep problems, constipation, pain and many others. You can find articles on these problems on the site.

Thankfully, DBS decreases many of these non-motor problems. For example, sleep improves after DBS. I, along with my colleagues at Kings college, published a research paper on improvement in sleep after DBS in 2018.

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DBS improves sleep and many other non-motor symptoms of Parkinson’s.

The effect of DBS on some non-motor symptoms is unknown. For example, we don’t know if DBS reduces excessive sweating and urinary problems.

Unfortunately, DBS may worsen a few non-motor symptoms.

  • If you already have thinking/memory problems, DBS may worsen them.
  • If you already have severe depression, DBS may worsen it.

This possible worsening is important to consider. Please read these two articles to know more: [Good DBS surgical candidate] [DBS risks].

 

Deep Brain Stimulation Success rate for Motor fluctuations

Before going on, let us look at the simple terms “OFF” and “ON”.

  • OFF is how a Parkinson’s patient is without symptoms – he/she has very severe symptoms.
  • ON is how a patient is when his treatment is working well – he has few symptoms.

In late Parkinson’s disease, medications effect becomes inconsistent. This causes “Motor fluctuations”.

Parkinsons Fluctuations
In late Parkinson’s disease, your day may seem like a roller coaster ride. You are ON during some hours, and OFF during other hours. These ups and downs are called “Motor Fluctuations”.

Let us look at the 2 most common motor fluctuations:

  • Some patients report that their medications stop working after a few hours. They become “OFF”. This is called “Predictable wearing-OFF”.
  • Some patients complain that their body shakes a lot after taking medications. This is called “Dyskinesia”.

DBS reduces these fluctuations. On average, patients get 4-5 hours of extra ON-time after DBS. This is the major success of DBS. Also:

  • Even when patients are OFF, their symptoms are less severe.
  • Dyskinesias improve. On average, Dyskinesias are reduced by more than 80%.

Deep Brain Stimulation Success rate for Quality of life

The goal of reducing your symptoms is to improve your quality of life.

So, the ultimate measure of Deep Brain Stimulation Success rate is an improvement in Quality of Life (QOL).

The distinction is crucial. For example, if your slowness decreases by 60-70%, your doctor would be happy. But are you satisfied? Has that enabled you to have a better life?

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DBS helps you become independent in your ADLs (Activities of Daily Living such as bathing, dressing, eating, etc.).

Does a high Deep Brain Stimulation Success rate enable you to have a better life?

Yes.

The evidence behind this is quite robust. In multiple studies, patients have reported improved quality of life after DBS.

For example, ADL means activities of daily living – bathing, dressing etc. Many patients can perform ADLs better after DBS.

For all these symptoms, the progression of underlying Parkinson’s itself may worsen QOL and ADL in some patients.

Improvement in movement (especially slowness) improves your quality of life. But, if your quality of life is low due to other symptoms such as depression, DBS may not improve it. These other factors need to be separately treated.

In how many patients does DBS fail completely?

About 10-15 %.

It is difficult to confirm that there is no improvement in ANY of the symptoms mentioned above. Medtronic reports this data on its website [here].

DBS Success rate
A few patients may not respond to DBS.

But that is not the end of the story. Some of these initial DBS failures can be converted into successes.

A recent study looked at 14 patients who initially did not respond to DBS. [Study available here]

This study was conducted by the University of Florida & Harvard University. A majority of these patients had been diagnosed with Parkinson’s disease before DBS.

The most common reasons for failure were:

  • Misdiagnosis. (the patient did not have Parkinson’s disease) [read more]
  • Incorrectly placed electrode. (the wire was not inside the DBS target) [read more]
  • Incorrect programming. (the DBS settings were not correct)
  • Incorrect medications (After DBS, the medications were not properly adjusted)

After they rectified these errors, 21 patients (slightly more than half) improved.

So, with careful post-operative care, the Deep Brain Stimulation Success rate may be higher.

Bottom line: How many patients are happy they had DBS

Here are the most critical questions. Are people who had the DBS happy with their decision? Would they recommend it to others?

This is an excellent way of measuring the Deep Brain Stimulation Success rate for Parkinson’s disease.

The results are very encouraging.

For example, in 2019, doctors from the University of Pennsylvania asked these questions to 320 patients who had DBS for Parkinson’s disease.

  • 92.5% of patients were happy with DBS.
  • 95% would recommend DBS to another patient with Parkinson’s.
  • 75% reported that it still controlled their symptoms.
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More than 90% of people who have DBS surgery for Parkinson’s disease are happy with it. Most of them would recommend it to others.

Keywords – DBS Surgery for Parkinsons Disease, Deep Brain Stimulation for Parkinson’s Disease, deep brain stimulation cost india, life after dbs surgery, how long does deep brain stimulation last, best hospital for dbs surgery, deep brain stimulation patient reviews, who is a good candidate for deep brain stimulation, deep brain stimulation parkinsons side effects

Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

Call 022-4897-1800

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NeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar IconNeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar

near LIC, Dr Balabhai Nanavati hospital, near LIC, Swami Vivekananda Road, LIC Colony, Vile Parle

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  • Avatar Paras Prabhu ★★★★★ 6 months ago
    Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted … More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
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    Dr Kharkar is gem of a doctor with tremendous patience, empathy, genuine concern for his patients .He guides them very methodically & scientifically … More for their neurological ill healthOur epilepsy patient is extremely happy with his treatment , Patient feels better by just visiting him too!May his selfless service to humanity flourish to reach all the needy patients!!
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    I consulted Dr Sidharth for my sister who has become very hyper and aggressive and we could not understand the issue. Keeping in mind she is someone with … More special needs Dr Sidharth was extremely understanding of the situation and did not put her through unnecessary investigation and avoided a very long stay at the hospital. He was infact more keen on her returning home to her natural environment. We highly appreciate Dr Sidharth for his effort and for looking into the matter with utmost care. It was a very difficult decision for my family to get my sister admitted but we are glad we did it under his care.Thankyou Doc.
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    my name is prashant purohit. I m become completely bed ridden from last 9 months and was unable to walk. I couldnt find out the cause even after visiting … More many doctors and many hospital in Ahmedabad nd jodhpur.started losing hope. A good friend of mine suggested to visit a neurologist. After searching a lot, I came to know about Dr. Siddharth Kharkar and took his appointment in Nanavati Hospital. He examined and said that he suffered from \u201cPKD(PAROXYSMAL KNESIGENIC DYSKNESIA\u201c. He assured us to reverse this in 5 days time. And indeed this happened. I started recovering miraculously. today I am fully well fit I m walking as normal . Many Many thanks to Dr. Siddharth Kharkhar sir for giving me a new life.
  • Avatar Sanjay Pradhan ★★★★★ 7 months ago
    Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond … More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
  • Avatar N N ★★★★★ 8 months ago
    We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications … More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
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    I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains … More the issue in much greater details. He has really been of great help. My father is much better now.
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    One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and … More cons.
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    Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for … More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
  • Avatar Hemant Kansara ★★★★★ 10 months ago
    Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed … More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you

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