Your brain is like a computer, commanding your body to perform certain tasks such as walking, lifting a glass to drink or instructing your hand to write with a pen. Your brain is like a computer, commanding your body to perform certain tasks such as walking, lifting a glass to drink, or instructing your hand to write with a pen. When the commands to control your movements are interrupted, you lose the ability perform everyday tasks, which can disrupt your life. Movement disorders can cause excessive or exaggerated movements, slowed movements and the inability to control voluntary movements.
Most people diagnosed with movement disorders are able to find relief through medical treatment. However, in some cases, medications fail to control the symptoms. For these patients, the Functional Neurosurgery Program at Northwestern Memorial Hospital offers hope by combining advanced technology and innovative surgical techniques to relieve the symptoms of movement disorders.
In the past, surgeons would create lesions in the brain, destroying the areas that were causing the disabling symptoms of movement disorders. More recently, deep brain stimulation (DBS) has proven to be a safe and effective treatment for select movement disorders. Conditions that may respond to this type of surgery include Parkinson’s disease (PD), dystonia and essential tremor.
DBS can be compared to a cardiac pacemaker. Much in the same way the cardiac pacemaker regulates and maintains an appropriate heart rhythm, DBS maintains appropriate electrical signaling in the brain. This is done by sending continuous electrical signals to the regions deep in the brain that control movement. This blocks the abnormal nerve signals that cause symptoms of PD, dystonia and essential tremor.
The DBS system consists of three components: the electrode (also called a lead), the extension and the neurostimulator. The electrode is a thin, insulated wire that is inserted through a small opening in the skull and implanted deep in the brain. The tip of the electrode is positioned in the area of the brain that has been identified to best relieve the patient’s symptoms. The extension is an insulted wire that is passed under the skin or behind the ear to the chest, connecting the lead to the neurostimulator. The generator (battery) for the neurostimulator is usually implanted under the skin just below the collarbone. Sometimes it may be implanted under the skin of the abdomen.
Northwestern Memorial Hospital’s Functional Neurosurgery Program is one of the leading programs in the Midwest and the first center in the Chicagoland area to use frameless technology to place deep brain stimulating electrodes without the use of the traditional confining and anchored stereotactic frame. In the past, patients would undergo the procedure by having a stereotactic frame attached to their skull with four pins. This would ensure the patient’s head was immobilized and that the placement of the electrodes was accurate. Today, nearly all patients who undergo DBS for relief of the symptoms of advanced Parkinson’s disease use stereotactic frameless technology. Instead of having a large, bulky frame attached directly to their heads, five small markers are attached to the skull through small incisions. With the use of a computer, CT and MRI images of the patient’s head are merged together. This gives the surgeon the ability to precisely locate the targeted areas of the brain relative to the markers placed on the patient’s head. During the procedure, the patient’s head remains unrestrained with the head and neck resting in a soft cradle. This innovative technology makes the surgery more comfortable, allowing the patient to move around a bit if needed to relieve stiffness or spasm.
Joshua M. Rosenow, MD, FACS, Director of Stereotactic and Functional Neurosurgery, was part of the team that refined this procedure, and he participated in some of the first fully-frameless deep brain stimulation procedures ever performed. The Functional Neurosurgery Program aims to provide the best outcomes with the goal of improving patients’ quality of life.
For more information about deep brain stimulation, call The Movement Disorders Center at 312-695-7950 or the Department of Neurosurgery at 312-695-8143. You may email us at dbs@northwestern.edu or visit our Web site.
Resources at Northwestern Memorial
Webcasts
Parkinson’s Disease: An Update
Diagnosis of Epileptic and Non-epileptic Spells
Programs
The Movement Center provides support groups, exercise programs and educational programs. View list of programs.
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