Dyskinesia is a medical symptom characterized by the involuntary movement of your hands, legs or other parts of the body. It can be treated by a variety of methods and these depend on the severity of symptoms, age of the patient, and a few other factors. Deep brain stimulation is a common method used to manage this condition and is one of the last treatment options for dyskinesia and tremors when the other methods have shown little to no effect on the symptoms.

What is deep brain stimulation?
Deep brain stimulation is a surgical procedure that involves the placement of a wire into a specific region of the brain. There are other treatments such as pallidotomy, thalamotomy, and subthalamotomy, which can also be used as treatment options for dyskinesia and tremors. Pallidotomy, in fact, may even have certain advantages over DBS as the latter requires implanted wires or batteries.

How does DBS work?
In this surgery, a thin wire, called DBS lead, is inserted into the brain. This wire has four electrical contacts at its tip, and the wire is placed carefully into the selected brain region. It can be placed in the globus pallidus internus, the thalamus, and the subthalamic nucleus. The procedure does not permanently destroy brain tissue, unlike the other procedures mentioned above and is potentially reversible.

In Parkinson’s disease, the substantia nigra pars compacta is a region in the brain where electrical signals are not processed normally. In this region, there are over 400,000 neurons that produce dopamine. As you age, those cells die, thereby gradually depleting. The reduction in the production of dopamine heavily influences the appearance of Parkinson’s disease symptoms. Placing the leads in this area can help smoothen the function of your brain and bring back the normal functioning of your body to an extent.

Sites where DBS is used
There are three different sites for deep brain stimulation therapy. They are as follows:

• Thalamus: It effectively reduces dyskinesia and tremors but is not as efficient with other Parkinson’s disease symptoms.
• Globus pallidus: This is one of the major interconnections to the substantia nigra pars compacta region. This reduces tremors, gait problems, dyskinesia, rigidity, and bradykinesia.
• Subthalamic nucleus: This is the other major connection to the SNc region. This also reduces tremors, dyskinesia and most of the other Parkinson’s disease symptoms.

Advantages of DBS
DBS helps to avoid most of Parkinson’s disease symptoms such as the ones given below.

• Dyskinesia
• Tremors
• Rigidity
• On/off fluctuations
• Dystonia
• Bradykinesia

In addition to these, it also helps in mood improvement, an increase in energy levels, and a general sense of well-being.

Eligibility For DBS treatment
Doctors in-charge heavily study the case of a patient before approving them for DBS therapy. It is important to keep in mind that DBS is not always necessary and the symptoms can be improved through other methods as well.

The criteria for DBS treatment are:

• You’ve been diagnosed with Parkinson’s disease at least five years ago.
• You have on/off fluctuations
• You have a positive response to Parkinson’s disease medications especially levodopa.
• You have tried many other methods to reduce symptoms with little to no success.
• Your symptoms affect your daily activities.
• You’ve tried other medications with no results.

DBS therapy is not recommended for you if:

• Your main symptoms are trouble with walking, bad balance, chills, etc.
• You are looking to cure impaired speech.
• You have confusion and memory loss on a daily basis.
• You have depression, anxiety, etc.
• You have other severe diseases or conditions.