Wednesday, September 10, 2008

Expertise counts with deep brain stimulation

Chicago Tribune
Judith Graham

Expertise counts with deep brain stimulation
With deep brain stimulation, as with many complicated medical procedures, it’s important to evaluate the expertise of physicians and hospitals before signing up as a patient.

This expensive treatment—it costs up to $150,000 or more--is now being offered by more than 300 medical centers across the U.S.

In a story today, I examine how physicians and scientists are exploring the use of the therapy for a variety of neurological and psychological conditions.

Currently, deep brain stimulation is approved by the Food and Drug Administration only for use in patients with Parkinson’s disease and essential tremor. Patients with dystonia can also get the treatment under a FDA humanitarian device exemption.

Hospitals’ experience with this therapy varies widely. Some centers treat up to 100 or more patients a year; others treat only a handful.

Some medical centers do extraordinarily careful workups to identify patients most likely to benefit from deep brain stimulation; others don’t.

Not all physicians carefully monitor patients who’ve had the procedure to make sure they’re deriving the maximum possible benefit.

And not all surgeons are expert at placing electrodes at exactly the right spot in the brains of patients. If the electrode is 1 or 2 millimeters off the rest of the story and comments

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