DBS - STN or GPi?

[Gaz1403]

I have been told by my neuro-team that STN DBS would be risky due to some bouts of depression I had last year and also the compulsive behavioural episodes I suffered while on Pramipexole.

They have recommended GPi DBS - has anyone on here undergone this procedure and, if so, was it successful?

Many thanks

Gary

[Sadiesadie15]

What is the difference?. I had DBS surgery and I suffer from depression but not impulse control. I had the surgery in 2004 and 2005 and my life has seen a dramatic turn for the better sinceI had it.

[hanifab23 in reply to Sadiesadie15]

do you feel better

[sailing1 in reply to Sadiesadie15]

Hi Sadie, i had DBS in 2008 not aware there was 2 types?? Like you a big change. For the better. Though not so good now, think its my meds.

[ancee]

I had GPi DBS a year ago. Not satisfied with the results so far. It takes more time to get programed I think.

I'm going to Denver next week to see Sierra Farris for a programming session. She's supposed to be very good.

[mktbob55 in reply to ancee]

She is a great programmer and nice also

[ancee in reply to mktbob55]

Have you had her program your transmitter? Did it help immediately? What were your symptoms? Mine is bradykinesia and dragging my left foot. Stiffness in my left leg.

[etterus]

Yes I have had the GPI procedure 12-12-14. I have had only one programming session to date. Thursday is my next which im looking forward to. I am better in many ways but still require the same amount of levodopa, 12-14/day to control the dystonia and bradykinesia. I never had tremors. My anxiety/depression is also better having successfully completed the surgery plus going to a gym regularly. STN usually allows the reduction of meds better but runs a greater risk of psych issues. I'm hoping that my doc writes a rx for the new Rytary med!

[toomuch in reply to etterus]

I'm confused, if you did not have tremor and still take 12-14 levodopa/day, then which symptoms led you to the decision to have the surgery and has there been any improvement on them specifically? Do you have dsykenisia with that much medication?

[etterus]

the symptoms that are much improved are foot dystonia and dyskinesias. The dyskinesias are probably 75% better. The foot dystonia is only 60 % better in that it is not as severe when I'm having an off period. I'm expecting this to be resolved with subsequent tuning. It is true that GPI placement requires more tuning time than STN. Also from what I've gathered is that the GPI is a better site for the non tremor pt's.

[Gaz1403]

Thanks for all that, etturus, that's very helpful.

Much appreciated.

Gary

[srarndt]

If you're going to undergo the DBS procedure be aware and informed that over the years, two main brain regions have emerged as possibilities: the subthalamic nucleus (STN) and the globus pallidus interus

(GPi). Which one is better? Yup! Will your neurosurgeon offer you a choice? Unlikely! Most seem to automatically choose the target they are most likely familiar with themselves. Is that bad or good?

YUP! It is good cuz they are better at hitting the desired target using the system they use most. It is bad if you do not know the pros and cons of either/both target.

What should you do? Research info on both targets online and discuss it in depth with your neurosurgeon and your Movement Disorder Specialist before they cranial drilling starts!

[etterus in reply to srarndt]

Soooo correct Steve

[llwwd]

Thanks to all for your info!