Rita Roeshot pulled her husband out of their car and helped him into his wheelchair. Her husband of 56 years was stricken with Parkinson’s disease and couldn’t walk or dress himself. As she wheeled him down the halls of Georgetown Medical Center and into the Neurology Department in May 2013, she hoped the procedure the doctors had performed two months ago would turn out to be worth it.
They had gone to Georgetown previously for a surgery called deep brain stimulation (DBS): a procedure that uses tiny electrodes attached to long, thin wires called “leads” that send electrical impulses to targeted areas of the brain. The leads are controlled by a device similar to a pacemaker that is implanted in the patient’s chest.
The stimulation can have a positive impact on a slew of symptoms, ranging from Parkinson’s to epilepsy to obsessive-compulsive disorder. Researchers are hoping it could one day be developed to treat even more conditions.
Today, Roeshot is accompanying her husband as the surgeon performs the final step of the procedure: the turning on and programming of Roeshot’s new wiring. She stands by her husband’s side as she watches his symptoms dissolve.
“Almost immediately, his legs became flexible again, and I could see the muscles in his face changing,” Roeshot said. “The blank mask of Parkinson’s disappeared, and the smiling face I remembered appeared again. He started rolling his wheelchair back and forth right in the office, just like a little kid.”
Georgetown isn’t the only facility performing DBS for patients like Roeshot. Last year, more than 65 DBS procedures were performed at Penn State Milton S. Hershey Medical Center. While brain surgery may have a reputation for being dangerous and complicated, DBS is different. Following the global trend of minimally invasive surgery, DBS is safe, gentle and reversible, and its effectiveness is changing lives one operation at a time.
Dr. James McInerney, who pioneered the DBS program at Penn State Hershey, has been performing the operation for more than 10 years and completes about two surgeries each week. Overall, Dr. McInerney has performed DBS on more than 300 patients, and none have chosen to reverse it.
“It really seems to work; many patients either lower their medication dosage or completely eliminate it after receiving the procedure,” said Dr. McInerney. “It’s hard not to get excited about that.”
While each surgeon has their own technique, they all have a common goal: to reduce the patient’s symptoms and increase their quality of life. McInerney uses a blend of IT and surgical technologies to carry out the planning, implanting and programming stages of DBS.
Creating a map to recovery
The first step is an appointment to take 3-D pictures of the patient’s brain and create a virtual model of a custom targeting platform — a star-shaped device the patient wears during surgery to aim the electrodes. McInerney uses a system called StarFix, which creates custom targeting platforms instead of the more traditional, manually adjusted ones.
McInerney first takes a series of CT and MRI scans of the patient’s head. Having both is important; CT scans are better at showing bone structure while MRI scans excel at detailing the brain. When combined, the two form a complete picture.