Deep Brain Stimulation

Here's how Deep Brain Stimulation works for Parkinson's Disease:

Implantation of Electrodes: During the DBS procedure, electrodes are surgically implanted into targeted areas of the brain. The most common targets for Parkinson's Disease are the subthalamic nucleus (STN) and the globus pallidus interna (GPi), although the choice of target may vary depending on the individual's specific symptoms and needs.
Implantation of Pulse Generator: A pulse generator, which is similar to a pacemaker, is implanted under the skin near the collarbone or in the chest. This generator is connected to the electrodes in the brain by thin, insulated wires running under the skin.
Programming and Adjustment: After the surgical implantation, the DBS system is programmed and adjusted by a specialized medical team. This team includes neurologists, neurosurgeons, and neurophysiologists. The programming involves fine-tuning the electrical stimulation parameters to provide optimal symptom control while minimizing side effects.
Continuous Stimulation: Once programmed, the DBS system delivers continuous electrical stimulation to the targeted areas of the brain. This stimulation can help regulate abnormal brain activity associated with Parkinson's Disease.

Deep Brain Stimulation can provide significant relief from the motor symptoms of Parkinson's Disease, including tremors, rigidity, and bradykinesia (slowness of movement). It can also reduce the fluctuations in symptom control may occur with medication alone.

It's important to note DBS is not a cure for Parkinson's Disease, and it does not stop the progression of the disease. However, it can improve the quality of life for many individuals with Parkinson's by allowing them to better manage their symptoms and reduce the need for high doses of medication, which can have side effects.

DBS is generally considered for individuals with Parkinson's Disease who meet certain criteria, including a good response to levodopa medication, significant motor fluctuations, and well-defined motor symptom patterns. The procedure carries some risks, including surgical complications and potential side effects from stimulation, which should be carefully discussed with a healthcare provider. Overall, Deep Brain Stimulation is an important therapeutic option for managing Parkinson's Disease, but it is not suitable for every patient, and the decision to undergo the procedure should be made on a case-by-case basis.

Elizabeth (Liz) Hitchings, Office Manager

Liz has been working for the practice for over 3 years. Prior to that she worked in skilled nursing facilities as a Life Enrichment Director/Dementia Practitioner. She loves supporting patients and their caregivers. Our practice offers expert level care in a community setting. Because of our association with an international research corporation we are also in a unique position to extend opportunities for treatments not otherwise available. She believes that it’s a pleasure to be a part of staff here who works as a team to provide education, support and as much as possible, a bit of amusement. Her goal is to help our patients maintain their independence and quality of life for as long as possible.

Kim Parker, Front Desk Coordinator

Years ago her grandfather was diagnosed with Alzheimer’s Disease then after taking care of her father her mother was diagnosed. She has worked in the medical field for over four decades as a Medical Biller but finds herself so fortunate to be working for this neurology practice as a Clinical Administrative Assistant in more of a “face to face” capacity with our patients. The years of experience supporting her mother through the disease was an education in what it takes to be a caregiver. She feels she developed more insight into what we can provide here to aid our patients and their support group. She feels she is especially blessed to be in an environment locally that can offer research trials that would not otherwise be accessible. She loves that the team here works to provide smiles every day to the ‘family’ that walks through our doors.

Kinan Hreib MD, PhD, MBA, Neurologist

Kinan Hreib MD, PhD, MBA, Neurologist

Dr. Hreib obtained his MD, Ph.D. and M.B.A. From Boston University and was trained in medicine and Neurology at Boston University Medical Center and Boston City Hospital. His professional life as a neurologist began at Lahey Clinic in Burlington, MA, where he was the director of Vascular Neurology for over twenty years, after which he became the chief of Neurology at Mount Auburn Hospital in Cambridge, MA before becoming the Chief Medical Officer for Baystate Health North. Dr. Hreib continued to see patients as a neurologist while the chief medical executive and later decided to join Donald Marks clinic on neurodegenerative disease in Plymouth.

Donald S. Marks, MD, Neurologist

Donald S. Marks, MD, Neurologist

For over 30 years, Dr. Marks has focused on the treatment of neurodegenerative diseases, specifically in the areas of Alzheimer’s and Parkinson’s disease. Dr. Marks has been the Principal Investigator (PI) in over 40 clinical trials with numerous pharmaceutical and imaging companies as well as with the National Institutes of Health (NIH). Dr. Marks is a member of the medical staff at the Beth Israel Lahey Health Hospital (BILH) Plymouth and the Nantucket Cottage Hospital. He is the founding Medical Director for the Division of Neurology at the BILH Plymouth.

What is Deep Brain Stimulation?

Positioning Head Frame, Setting up implantation trajectory, Scalp and skull entry

Insertion of Deep Brain Stimulation Electrodes

Coronal view (image slices from front to back of head) brain MRI, showing location of implanted electrodes)

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Jody Hiltz, Front Desk Coordinator

Elizabeth (Liz) Hitchings, Office Manager

Kim Parker, Front Desk Coordinator

Morgan Tromblee, PA-C

Elizabeth (Lizzy) Simpson, PA-C

Kinan Hreib MD, PhD, MBA, Neurologist

Donald S. Marks, MD, Neurologist