Published: Wednesday, October 17, 2012 at 5:40 p.m. Last Modified: Wednesday, October 17, 2012 at 5:40 p.m.

A decade ago, deep-brain stimulation for Parkinsons disease was considered a risky procedure. Today, its on the cutting edge of personalized medicine, and researchers at the University of Floridas McKnight Brain Institute are at the forefront of its evolution.

When we started in 2002, there were only a handful of places in the U.S. that did it. There was a lot of skepticism about the operation from internists and neurologists, said Dr. Michael Okun, a neurologist at UF. Now it has gone from crazy to cool to completely accepted.

Okun published an article today in the New England Journal of Medicine that explains how the procedure is helping with Parkinsons disease and other neurological conditions such as obsessive compulsive disorder, Tourettes syndrome and depression.

Okun and Dr. Kelly Foote, a neurosurgeon at UF, have performed more than 800 procedures in the past decade, mostly in Parkinsons patients whose medications have become less effective, leading to complications such as on-off fluctuations.

During the off periods, the medication stops working and patients symptoms such as tremors or immobility worsen. This happens in most patients after about five years, said Okun, and patients with off periods of more than three hours a day are good candidates for deep-brain stimulation.

During the procedure, doctors first identify the part of the brain to target. For most patients, that will be either the subthalamic nucleus or the globus pallidus, two tiny sites involved in controlling movement.

Doctors then drill a dime-sized hole in the skull so they can place a lead that delivers electric current to the troublesome spot responsible for the degeneration caused by the disease.

You want to make sure that you take your time and get it right. Those leads have to be within a half-millimeter to work their magic, Okun said.

Deciding where to place the lead also depends on the patient. If you see a patient and tremors are important maybe they are a dentist or a chef, they might choose one target in the brain. If its a singer or trial litigator, they may target another part of the brain.

Continued here:
UF: Deep-brain stimulation helping with OCD, Tourette's, along with Parkinson's