Deep Brain Stimulation v Focused Ultrasound: Which Is the Right Option for You?

Have you ever wondered whether you might benefit most from deep brain stimulation (DBS) or focused ultrasound? Join us for a conversation about the unique benefits of each therapy.
Dr. Ausaf A. Bari, MD, PhD, specializes in the neurosurgical repair and restoration of brain and nerve function. Following his neurosurgery residency training at UCLA, Dr. Bari was awarded the prestigious William P. Van Wagenen Fellowship to train at the world-renowned functional neurosurgery program at the University of Toronto.
He has extensive clinical and research experience in the use of deep brain stimulation (DBS) in the treatment of both movement and psychiatric disorders. Dr. Bari’s clinical practice includes DBS surgery for Parkinson’s disease, tremor, dystonia, depression and OCD.
A Parkinson's Community Los Angeles (PCLA) "Let's Talk Parkinson's" online live program from January 18, 2024. www.pcla.org.
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Timestamps:
00:00 Welcome
01:06 Speaker Intro
02:44 Functional aka Restorative Neurosurgery
03:27 Historical “Restorative” Neurosurgery
05:30 Why did these techniques fall out of favor?
06:48 Contemporary Restorative Neurosurgery
07:38 Deep Brain Stimulation
08:41 DBS for Parkinson’s Disease
11:57 DBS Treatment Pipeline
15:34 DBS Targets for PD
17:18 GPi vs. STN
18:57 Direct Targeting
19:35 Indirect Targeting
20:28 Connectivity-Based Thalamic Map
21:00 Leksell Coordinate System
22:49 Frame Placement
25:04 Recording Signals
25:22 Microelectrode Recording
26:06 Awake Testing During Surgery
27:38 Side View of Brain w/ DBS Electrode in Place
33:17 Potential Risks of DBS Surgery
35:09 Patient Example
35:46 Timing of DBS Surgery
37:30 DBS for Essential Tremor
39:07 Patient & Provider Expectations
39:29 Therapies for Tremor: Looking Beyond DBS
40:04 Noninvasive Treatment of Tremor: Radiosurgery
41:15 FUS Essential Tremor
42:43 Continuous monitoring: clinical & imaging
47:00 Clinical Trial Results
47:07 MRgFUS Considerations
49:52 Comparison of Options
51:08 Q&A
01:00:37 Outro
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🎥 Related Content:
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PCLA's online events are intended as an informational and educational resource for the Parkinson's community. Always consult with your healthcare team for medical and treatment advice. The views and opinions expressed by presenters and participants do not necessarily reflect those of PCLA. Sponsorship support does not influence PCLA's content perspective or panelist selection.
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[@SHAKEANDWATCH]

Feeling ok. Balance a bit compromised but no tremor

[@SHAKEANDWATCH]

Great presentation Dr Bari. I had bilateral Stn dbs in November done but Professor Zrinzo in London. What a positive result. I’m indebted to all of you who work and evolve this technology . My procedure (inc Boston Scientific stimulator) was all done under General Anaesthetic

[@qujelqujel1]

How r u now?

[@laggerb4680]

As one who does both DBS & FUS can you determine which is actually a better option for a patient. Or is it more a patient preference?
I have both resting & active tremor, which has become worse in the last 2 yrs & is my main symptom. Levodopa (or other meds) do not do anything for me that I can notice. I am a 78 yr old female in good health.

[@ParkinsonsCommunityLosAngeles]

if you've watched the video, and didn't get an answer to your question, please see a doctor with this question.

[@kemchobhenchod]

Wish there was more quantitative information about long term efficacy of bilateral FUS vs DBS (ie. % effectiveness after 5 years, 10 years etc)