We are experts in deep brain stimulation, high-intensity focused ultrasound and spinal cord stimulation.

The Center for Neuromodulation at The Ohio State University Wexner Medical Center is one of the nation’s leading centers in developing neuromodulation treatments for a wide range of diseases and conditions. Neuromodulation, which involves the use of implantable devices that alter nervous system activity through the use of electrical stimulation, is one of the fastest-growing medical specialties.

Our neuromodulation team is among the most experienced in the country. We perform a variety of treatment options including deep brain stimulation, high-intensity focused ultrasound, and spinal cord stimulation. Deep brain stimulation is a procedure that can treat patients who have Parkinson’s disease, essential tremor, dystonia and obsessive compulsive disorder. High-intensity focused ultrasound, also known as focused ultrasound ablation, is a noninvasive procedure that can treat patients who have essential tremor and Parkinson's tremors. Spinal cord stimulation, or peripheral nerve stimulation, is a therapeutic procedure designed to manage chronic pain for patients with occipital neuralgia failed back syndrome, radicular pain syndrome, post-laminectomy pain, peripheral neuropathy and complex regional pain syndrome. 

Why choose the Ohio State Center for Neuromodulation?

Nationally Recognized: Ohio State is routinely recognized for our excellence in neurosurgery, neurology and neuromodulation.

Unique in the Region: Ohio State is the only healthcare facility offering deep brain stimulation (DBS)  and high-intensity focused ultrasound (HIFU) in central Ohio.

Most Experienced Neuromodulation Team in the United States: The physicians of the Center for Neuromodulation at The Ohio State University Wexner Medical Center perform thousands of neuromodulation surgical procedures each year for patients with Parkinson’s disease, essential tremor, dystonia, traumatic brain injury and obsessive compulsive disorder.  

Research: We are exploring how deep brain stimulation, high-intensity focused ultrasound and spinal cord stimulation can treat other chronic disabilities and diseases.


Learn more about brain and spine neurological conditions at The Ohio State University Wexner Medical Center.

Deep Brain Stimulation

What is Deep Brain Stimulation?

Deep brain stimulation (DBS) is a commonly performed surgical procedure for patients with Parkinson’s disease, essential tremor or dystonia. DBS treats a variety of disabling neurological symptoms including tremor, rigidity, stiffness, slowed movement and walking problems.

DBS electrodes are implanted into the brain and connected to a small pacemaker-like programmable device that has been implanted into the chest or abdominal wall (no exposed hardware). The electrodes deliver tiny electrical signals that calm abnormal brain signals, alleviating disabling symptoms, such as tremors, and restoring function to the patient.

We frequently treat patients with these diagnoses: 

DBS for Essential Tremor

DBS is considered when patients with persistent and severe tremor are not receiving significant benefits from medications or the side effects are too severe.

DBS for Parkinson's Disease

DBS is considered when a patient has idiopathic Parkinson’s disease and one of these issues:

  • Debilitating hand or leg tremor that fails to respond to medications
  • Idiopathic Parkinson's disease with continued good benefit from treatment with medications, but with frequent return of disabling rigidity, slowness of movements, tremor due to "on-off" fluctuations or excessive uncontrollable movements called “dyskinesia”
  • Idiopathic Parkinson’s disease but failure to tolerate all Parkinson’s medications due to severe side effects

DBS for Dystonia

DBS is considered when a patient has significant debilitating symptoms of primary dystonia and has failed to respond to oral medication, botulinum toxin therapy (Botox) and other treatment modalities.

DBS for Obsessive Compulsive Disorder

DBS is considered when a patient has severe OCD symptoms that have lasted for more than five years and have failed to respond to medication and cognitive therapies.

Spinal Cord Stimulation

What is Spinal Cord Stimulation?

Spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) involves electrical stimulation of the spinal cord to interrupt pain signals from the spinal cord to the brain. It is a proven, safe and effective therapeutic approach for managing chronic pain of the neck, back, arms and legs, which may occur following spinal surgery. A medical device similar to a pacemaker, which is placed beside the spinal cord or peripheral nerve, is used to deliver mild electrical impulses before pain signals arrive. Instead of pain, patients feel a tingling sensation from the neurostimulation in areas where the pain is felt. 

Who should consider SCS or PNS?

SCS or PNS can benefit you if you have chronic pain of the neck, back, arms and legs occurring as a result of spinal surgery. Some of the conditions treated include:

  • Failed back surgery syndrome
  • Post-laminectomy pain
  • Peripheral neuropathy
  • Complex regional pain syndrome (also known as reflex sympathetic dystrophy) 
  • Occipital Neuralgia

You may want to consider SCS when:

  • Other treatment options have failed to adequately provide pain relief
  • Your doctor understands what is causing your chronic pain
  • Further traditional surgeries are not recommended
  • You don’t have a serious, untreated dependence on pain medication
  • You have passed a psychological evaluation
  • You don’t have medical issues that would make surgery difficult
  • You have had a successful neurostimulation screening test

Benefits

Overall benefits of SCS or PNS may include:

  • Significant and sustained reduction in back and leg pain
  • Improved ability to function and participate in activities of daily living
  • Fewer oral pain medications
  • Ability to stop the therapy by turning it off or surgically removing the SCS device
  • Ability to adjust the therapy based on pain level
  • With improvements in a person’s pain, the potential ability to participate in other forms of therapy to better manage the pain

How is SCS/PNS performed?

SCS/PNS is performed in two phases. A “trial” phase is done first to see if you can get pain relief from the device. This is normally done as an outpatient procedure , the electrodes stays in place for five to seven days. If there is pain relief, a permanent device is implanted, which requires another outpatient surgical procedure.

It is important to know that this procedure may reduce but not cure your pain. You may feel a tingling instead of the pain, and it may improve your ability to function.

You may want to consider SCS/PNS when:

  • Other treatment options have failed to adequately provide pain relief
  • Your doctor understands what is causing your chronic pain
  • Further traditional surgeries are not recommended
  • You don’t have a serious, untreated dependence on pain medication
  • You have passed a psychological evaluation
  • You don’t have medical issues that would make surgery difficult
  • You have had a successful neurostimulation screening test 

How can I be evaluated?

If you are interested in becoming a candidate for spinal cord stimulation or peripheral nerve stimulation, you must have a physician referral. Contact your healthcare provider for an initial evaluation and referral to Ohio State’s Center for Neuromodulation. Your healthcare provider will complete a referral form and submit it to our center. You will then be scheduled to receive a comprehensive screening and evaluation by our multidisciplinary team. 

It is important to know that SCS may reduce but not cure your pain. You may feel a tingling instead of the pain, and it may improve your ability to function.

High-Intensity Focused Ultrasound

What is High-Intensity Focused Ultrasound?

High-intensity focused ultrasound (HIFU) is an innovative, noninvasive procedure that can treat patients who have essential tremor and Parkinson’s tremors – in a single session.

HIFU provides real-time monitoring and precise targeting, while painlessly treating tissue deep in the brain. There are no incisions, anesthesia or radiation with this magnetic resonance-guided focused ultrasound. A machine gives off high-frequency sound waves that deliver a strong beam to a specific part of the brain containing nerve cells causing the tremors. Some cells die when this high-intensity ultrasound beam is focused directly onto them, eliminating the tremors.

The Ohio State University Wexner Medical Center was one of the first in the country – and the only one in the Midwest – to study HIFU’s safety and effectiveness as part of a multi-center FDA trial.

Who should consider HIFU?

  • Patients suffering from Parkinson’s disease, essential tremor, a disabling movement disorder or other tremor disorder
  • Patients who experience dyskinesia, which causes the involuntary movement associated with Parkinson’s, as a result of taking medication used to treat the disease
  • Patients who have not responded to medication or are not candidates for alternative surgical treatments
  • Older patients who are not good candidates for traditional deep brain stimulation (DBS) pacemaker surgery
  • Patients unwilling or unable to undergo invasive surgery

Which diagnoses does HIFU treat?

HIFU eliminates tremors caused by movement disorders and other tremor disorders.

How is HIFU performed?

A patient scheduled for a HIFU treatment can expect his or her surgery to last around four hours. The patient’s head is shaved and fitted into a halo frame to hold it steady for an MRI. 

Performed in the intraoperative MRI-surgical suite, the surgery requires the patient to be awake and respond to and interact with the neurosurgeons as the surgery progresses. This real-time feedback guarantees the surgeons are precisely targeting the brain cells that control involuntary movements with 1,024 beams of ultrasound.

The patient’s scalp is submerged in water to help with wave conduction and to keep the head cool. From a neighboring room, the doctors and technicians deliver a dozen or so 10- to 13-second rounds of ultrasound.
 

How quickly does HIFU work to stop tremors?

Immediate results are evident when the surgery is done. Because the surgeon and patient communicate throughout the surgery, there is no waiting to know if tremors are eliminated. This is a permanent treatment because the brain cells causing the tremor are burned away. Patients recover rapidly and can quickly return to activities of normal life – usually the next day.

What are the benefits of HIFU?

Patients who have a HIFU treatment can expect to regain independence and their normal activities to some degree. With HIFU, our hope is to improve quality of life and functionality by decreasing motor disability.

How can I be evaluated?

If you are interested in becoming a candidate for high-intensity focused ultrasound, you must have a physician referral. Contact your healthcare provider or neurologist and ask them to forward your medical files to Ohio State. Your healthcare provider will complete a referral form and submit it to our center. You will then be scheduled to receive a comprehensive screening and evaluation by our multidisciplinary team to see if the therapy might be right for you. 

 

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