A Decision Aid For Deep Brain Stimulation (DBS) Surgery An advanced therapy option for people with Parkinson’s Disease
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Benefits: Interactive
Click on the symptoms that you experience to find out if and by how much they are expected to improve with DBS. Scroll down below the table to see the results.
Check all that apply. Print your personalized report below.
On average, people who get DBS will experience the following benefits. Because these are averages, the exact benefits will be different for each person.
Overall motor (movement) symptoms improve on average by 50-70% after DBS. The most improvement occurs in shaking (tremor), followed by stiffness, and then walking. The least amount of improvement is seen in slowness of movement.
Personalized Symptom Report
Slowness
Slowness of movement is expected to improve by about 30-40%, meaning people may notice that movements are faster and more fluid.
Stiffness
Stiffness is expected to improve by about 50%.
Shaking (Tremor)
Shaking is expected to improve by about 60-80%. This means there is less time with tremor and less severe tremor when it does occur.
OFF Time (when medications are not working well)
Off time is decreased by about 70%.
For example, if you have a total of 4 hours of OFF time per day before DBS, you would have just over 1 hour of OFF time per day after DBS. ON time may become more consistent.”
Dyskinesia (involuntary movements from levodopa)
Dyskinesia is decreased by about 60-70% after DBS.
People may experience this improvement as less time with dyskinesia and/or less bothersome dyskinesia if it does occur. The GPi target may directly decrease dyskinesia and may decrease dyskinesia more than the STN target.
Walking Trouble/shuffling
Walking is expected to improve by about 40-45%.
People may experience this improvement as less shuffling when walking and bigger steps.
Freezing of gait (feet sticking to the floor)
Freezing of gait may improve with DBS if it also improves with carbidopa/levodopa. Freezing is less likely to improve with DBS if it does not improve with carbidopa/levodopa.
In one study of DBS, about half of the patients who had freezing of gait before DBS no longer experienced freezing after DBS.
Dystonia (toe curling, foot turning inward)
Dystonia can improve with DBS. Studies are currently ongoing to see how effective DBS can be for Parkinson’s related dystonia.
Medications
The number of Parkinson’s pills may decrease by half or more, which may also decrease side effects from medications.
For example, if you take 12 pills per day for Parkinson’s disease before DBS, you would take 6 pills or less per day after DBS.
This decrease in medicines does not apply to people who get DBS in the globus pallidus (GPi).
Quality of Life and Daily Activities
People may experience improvement in the ability to cook, look after their home, get around in public, get dressed, exercise and participate in leisure and social activities. Some people may also feel less embarrassed and more confident going out in public.
The ability to complete daily activities of living improves by about 40-50%.
Balance Trouble
Trouble with balance is not expected to improve with DBS, however, results from smaller studies have been mixed. If balance clearly improves with carbidopa/levodopa, it may improve with DBS. Other studies have shown that balance may mildly worsen after DBS.
Thinking/Memory Problems
Thinking and memory problems are not expected to get better with DBS. Some studies show that people have more trouble with verbal fluency after DBS, which is how easy it is for you to come up with words. Often this trouble is only detectable on memory tests and not noticed by the person with DBS. Other times, the person with DBS may notice some trouble coming up with words.
Depression and Anxiety
Studies have shown mixed results of the effect of DBS on depression and anxiety. In some studies, people have reported some improvement in depression and anxiety symptoms, while other studies have shown no change.
Apathy (lack of motivation)
Apathy is not expected to get better with DBS. In fact, it can sometimes get worse as dopamine medications are decreased for those who receive STN DBS. For those who receive GPi DBS, apathy may remain unchanged.
Constipation
Constipation is not expected to get better with DBS.
However, some studies have suggested that constipation can improve for some people after DBS, so more studies in this area are needed.
Bladder Issues
Bladder issues, such as frequent urination, urgency and incontinence, are not expected to get better with DBS
Changes in voice or speech
Changes in voice, such as speaking more softly, are not expected to get better with DBS.
Acting out Dreams (REM Sleep Behavior Disorder)
Acting out dreams is not expected to get better with DBS.
Sleep Problems
Sleep problems are not expected to get better with DBS. However, there are studies that show that sleep may improve after DBS but more research is needed to know for sure.
