The Benefits of Deep Brain Stimulation to Treat Essential Tremor
If you have been diagnosed with essential tremor (ET), everyday activities that you used to take for granted may now seem impossible. Once simple tasks like getting dressed in the morning or pouring a cup of coffee can be difficult to accomplish, leaving you feeling defeated and frustrated.
ET is a progressive neurological disorder, characterized by involuntary shaking – or tremors – of the hands or other body parts. The tremors most often occur when the affected muscles are in use. The signs and symptoms of ET begin gradually over time and usually are more prominent on one side of the body.
While ET is not life-threatening, it is not a normal part of aging and it can dramatically impact your quality of life. The good news is that there are several options for treatment, including medications, therapy, and surgical intervention.
The most effective treatment for ET, Deep Brain Stimulation (DBS) is a minimally invasive surgical procedure, using a neurostimulation device — similar to a heart pacemaker — to deliver electrical pulses to the specific place in the brain that coordinates and controls muscle activity. Often resulting in an 80 percent decrease in tremor, improvements caused by DBS can last for several years.
The science behind DBS has been proven over centuries of experimentation and study. Since ancient times, electrical stimulation has been used for therapeutic purposes. In fact, Scribonius Largus used shocks from torpedo fish in AD 46 to treat headaches, depression, and epilepsy – a very early predecessor for DBS! Centuries later in 1987, Alim-Louis Benabid, a neurosurgeon at the University Hospital of Grenoble, France, and his colleagues heralded the modern era of DBS. Their research proved that high-frequency electrical stimulation in the brain could effectively treat tremors. In 1997, the U.S. Food and Drug Administration approved DBS as a safe and efficacious treatment for ET.
Over the past 20 years, more than 160,000 patients have received this surgery with generally positive and long-lasting outcomes. Patients have reported overall improvement in activities of daily living, significant reduction in tremor, and decrease in the medical severity of the condition. Studies have also confirmed the long-term efficacy of the use of DBS to suppress tremor.
Dr. Deborah Boland, Neurologist, Movement Disorder Specialist, and owner of Tampa Bay’s Be Mobile Neurology, is a local expert in DBS. She recommends DBS for ET patients who are experiencing persistent tremor despite medication, side effects from medication, or symptoms that are severely interfering with quality of life. The DBS surgery will not cure your ET, but it can help reduce symptoms, allowing you to reclaim your independence.
So how does DBS work? A DBS system is like a pacemaker for your brain, using a small battery-operated device called an internal pulse generator (IPG) and tiny electrodes. During the surgery, the IPG is placed in your abdomen or chest, and the electrodes are placed in the specific areas of your brain that control movement. The IPG sends steady, low-voltage pulses of electricity to the electrodes, correcting the faulty brain signals that cause essential tremor.
The benefits of treating ET with DBS include:
- Long-lasting treatment to reduce or eliminate tremors
- Improvement of quality of life
- Personalized settings to treat your specific symptoms
- Continuous therapy delivered 24 hours a day without wearing off
- Less dependence on medication to control symptoms
- Easily adjustable by your neurologist to maximize effectiveness and to minimize side effects
- Reversible nature that won’t limit your future treatment options
- Most beneficial for people with hand and arm tremor caused by ET
- Less side-effects than other surgical options for ET, such as thalamotomy
Dr. Boland says that post operation programming, beginning three to four weeks after surgery, is essential to ensure optimal treatment. Once settings are stable, Dr. Boland continues to meet with patients every three months for the first year to evaluate progress. Depending on the patient’s symptoms and settings, they will be seen two to four times a year moving into the future.
Continued DBS research is leading to continued medical advancements in the field and the development of new technology. Dr. Boland works closely with technology partners Medtronic Deep Brain Stimulators, Boston Scientific, and St. Jude Abbott to ensure her patients are receiving cutting-edge health solutions.
However, for patients with voice and head tremor, medications may remain the best treatment option. Dr. Boland will work with you to determine the most effective way to manage your ET, based on your individual symptoms.