Deep brain stimulation (DBS) improves many of the motor symptoms of Parkinson's disease (PD) and is a life-alerting surgery for many patients. Penn Medicine's Gordon Baltuch, MD, a professor of Neurosurgery and director of the Penn Center for Functional and Restorative Neurosurgery, is one of the most prolific DBS surgeons in the world, having recently performed his 1,000th procedure, marking an important milestone for Baltuch and Penn Medicine.
The intricate procedure requires the insertion of two insulated wires deep in the brain to reach the brain structures that cause many of the tremors and involuntary movements that are the hallmark of PD, when medications fail. DBS surgery is only performed at approximately 1,000 centers around the world.
"I am thrilled to have impacted so many patients in a positive way," Baltuch said. "Parkinson's disease can rob patients of their quality of life, physically, emotionally and socially. To be able to give them some of that back is an amazing feeling."
DBS was approved by the U.S. Food and Drug Administration (FDA) in 1997 for the treatment of tremor, with approval for PD following in 2002. Baltuch has performed approximately 100 DBS surgeries annually since FDA approval.
The procedure uses two very fine insulated wires made up of an electric lead and an extension and threads them deep into the brain. The lead is thread into the subthalamic nuclei, the two Rice Krispy-sized structures responsible for much of the tremor in PD patients. The extension connects to the lead and runs below the skin, from the head, down the side of the neck, to the stimulator, which is placed under the skin near the collar bone.
The stimulator acts as a pacemaker for the brain, sending high frequency electrical impulses to mitigate the symptoms of PD. At Penn, unlike other Centers, the entire procedure is performed in one stage, and stimulator is activated the day after surgery and programmed to personalized settings. "Our movement disorder neurologists program the stimulators and adjust patient's medications," Baltuch said. "There is a fine interplay between the two."
While DBS is primarily used in the treatment of patients with essential tremor, PD, and dystonia, Baltuch has been a leader in the research on the procedure, participating in clinical trials to test its use in patients with epilepsy, major depression, and Alzheimer's disease.
"I am very proud of Dr. Baltuch's efforts on behalf of so many patients with Parkinson's disease," said M. Sean Grady, MD, The Charles Harrison Frazier Professor of Neurosurgery and chair of the department of Neurosurgery. "It is a privilege to have him as a member of our department. He stands out as a superb academic neurosurgeon." Baltuch has performed all 1,000 surgeries at Penn Medicine's Pennsylvania Hospital.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania(founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $5.3 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 17 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $409 million awarded in the 2014 fiscal year.