[Daves1]

1/20/19 . Does DBS directly affect non-motor PD symptoms?
Hi- I am a 51-year-old physician-I was diagnosed with PD diagnosed 10 years ago. It has remained asymmetric and my “on” exam is the same as at diagnosis. Obviously, I am on much more medication-I take Entacapone every 2 1/2 hours, I have off periods which can be awful-lately for approximately30 minutes after I take the l-dopa—it is very dependent on my GI function. I do get bad foot dystonia approximately every 3 days, and most importantly, in large part due to my family dynamics, I have developed a severe anxiety disorder. I don’t jhave any significant dyskinesia. My motor guy recommended DBS- mostly because of the fact that I still have. Good exam at 10 years and no dystonia, though he definitely thinks I t will have a big effect on my anxiety/panic- which obviously makes my PD manifestations much worse! I have written that PD is the ideal example for the negative vicious cycle Since it is all connected in myriad ways-DBS has the potential to help my anxiety via less dystonia-less off-less meds; does anyone know if it can have any direct effects on mood or psychologic expressions of PD. The neurosurgeon that I had an initial consult with told me I could be completely sedated, and it has been shown to have identical results with an awake procedure! (though I liked this answer- I would think awake would be optimal. There is no doubt that the placebo effect is very active in PD and if I think that my support systems is my biggest problem-I wonder if it will be less efficacious. Also- exercise/weight training is a huge part of my life and mood. I am interested in people’s experience with how obtrusive the generator.is, -especially in the gym. In addition. i know that her is theoretically no difference in outcome between awake/anesthetized patients. does anyone have any insights into this?

Dave