New technique for deep brain stimulation surgery proves accurate and safe
June 10, 2013
Oregon Health & Science University neurosuirgeons have developed a safer new way to perform the surgery for Parkinson’s disease. It allows for more accurate placement of the brain electrodes and is likely safer for patients.
The success and safety of the new surgical technique could have broad implications for deep brain stimulation,(DBS) surgical procedures.
With traditional DBS surgery, there is a small chance of hemorrhaging in the brain as the surgeon places or moves the electrodes to the right spot in the brain. Patients are also asleep during the surgery, rather than being awake under local anesthesia to help surgeons determine placement of the electrodes.
“I think this will be how DBS surgery will be done in most cases going forward,” said Kim Burchiel, M.D., F.A.C.S., chair of neurological surgery at Oregon Health & Science University and the lead author of the Journal of Neurosurgery article.
The surgery involves implanting very thin wire electrodes in the brain, connected to a neurostimulator implanted in the chest. The system then stimulates the brain to often significantly reduce the tremors.
The new technique uses advances in brain imaging within recent years to place the electrodes more safely and more accurately than in traditional DBS surgery. The surgical team uses CT scanning during the surgery itself, along with an MRI of the patient’s brain before the surgery, to precisely place the electrodes in the brain, while better ensuring no hemorrhaging or complications from the insertion of the electrode.
The Journal of Neurosurgery article reported on 60 patients who had the surgery at OHSU over an 18-month period beginning in early 2011.
Burchiel and his team have done another 140 or so surgeries with the new procedure since enrollment in the study ended. OHSU was the first center to pioneer the new DBS procedure, but other surgical teams across the U.S. are learning the technique at OHSU, and bringing it back to their own centers.
DBS surgery often helps significantly reduce tremors in patients with familial tremor and tremors and other symptoms in Parkinson’s disease. A parallel study is ongoing at OHSU to assess how symptoms of the patients have improved since their DBS surgery using this new method.
DBS surgery has shown promising results in clinical trials with some Alzheimer’s patients, with some forms of depression and even with obesity.