Delving Into DBS

Delving Into DBS

Implanting electrodes into the brain may sound like science fiction, but an innovative treatment performed at Jewish Hospital, part of KentuckyOne Health, called deep brain stimulation (DBS) uses that exact process to treat movement disorders.

Movement disorders affect people’s ability to move, walk, speak and otherwise function normally. Many of these issues are caused by malfunctions in the neural processes and circuits of the brain.

“DBS helps stop irregular neural firing and encourages a normal pattern of brain activity,” said Joseph Neimat, MD, chairman of the Department of Neurosurgery at the University of Louisville, who performs the procedure at Jewish Hospital. “The results are amazing.”

Circuit Work

Traditionally, medications are used to treat movement disorders, but over time, they may become less effective. DBS uses electrodes to pulse electricity to the proper area of the brain and alleviate symptoms — often yielding lasting, reproducible results.

“DBS alters the brain’s circuits in the same way as medications, but it does so in a more predictable and measured way,” Dr. Neimat said. “The therapy produces consistent benefits, and can truly change the quality of patients’ lives.”

Prep and Programming

Patients work closely with a team of neurologists, neurosurgeons and other providers to prepare for the two procedures necessary to begin DBS therapy.

First, MRIs, CT scans and microelectrodes are used to discover the area of the brain that is malfunctioning. Once the proper area is found, one or more neurostimulator electrodes are placed in the brain. Patients normally return home the day after this procedure.

A week later, patients return to the hospital for a second surgery. The electrodes are connected to a battery that is implanted in the chest. Over the next few months, providers work with the patient to program the electrodes and make sure they are stimulating the brain with the correct charge, amplitude and frequency.

“Patients who find that their medications are losing effectiveness should definitely consider DBS,” Dr. Neimat said. “The surgery is very safe and effective and changes patients’ lives for the better.”

Movement Disorders Program at Frazier Rehab Institute

Through a partnership with the University of Louisville, the Movement Disorders Program at Frazier Rehab Institute, part of KentuckyOne Health, provides a comprehensive approach to care for individuals with Parkinson’s disease and other movement disorders. For more information, call 502.582.7654.

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

A New Solution for MS

A New Solution for MS

A medication called Ocrevus offers new hope to patients living with multiple sclerosis (MS). KentuckyOne Health neurologist Cary Twyman, MD, is a key player in research for the new therapy.

Until the early 1990s, patients living with MS didn’t have many options to manage the neurological disease that slowly chips away at life. Impacting the central nervous system, specifically the brain, optic nerves and spinal cord, MS depletes the protective myelin sheath surrounding these vital structures. This makes it difficult for the brain to send messages to the rest of the body.

As a result, patients with MS can experience unpredictable and often devastating symptoms, including chronic pain, difficulty moving, fatigue, numbness, tingling and loss of vision.

The past 24 years have seen an increase of therapies to slow the progression of MS. However, there is still no cure for the disease. And until March 2017, there were virtually no options to manage the condition’s primary progressive stages, which are marked by a steady worsening of the disease and function of the body.

The Anatomy of an Answer

A new drug recently approved by the U.S. Food and Drug Administration is the first of its kind for patients living with advanced MS. Ocrelizumab, which is sold on the market as Ocrevus, reduces the number of a certain type of cell that may damage nervous system tissues in patients with MS.

“Ocrevus is one of many precision medications coming down the pike and is currently the best option to slow progression of advanced MS,” said Dr. Twyman, who is medical director of KentuckyOne Health Multiple Sclerosis Care in Lexington. “As we continue to expand choices that effectively and safely treat MS in its various stages, the world will be a better place for patients in the future.”

Dr. Twyman was closely involved in the clinical research of Ocrevus, which was tested in three trials, including one specifically for patients with advanced MS. As clinical trials for a precision medication, these focused on improving medication delivery for the best outcome for individual patients.

Specialized Care

Patients and families living with multiple sclerosis can find the comprehensive care that they need at KentuckyOne Health Multiple Sclerosis Care. This center is specifically designed to enhance quality of life by offering a robust spectrum of services, including medication management, occupational, physical and speech therapies, social work services, and research trial information and enrollment support. Call 844.739.2997 for more information.

This article originally appeared in the 2017 Summer edition of One Health Magazine. Sign up for your free subscription.