First, let me say that the decision might not be mine to make. Having either of these surgeries done is dependant upon me being approved and qualifying for the respective study that they have ongoing. I may only qualify for one study, in which case the decision is made for me, or I may not qualify for either study, which would be really disappointing.
I must also say that I am lucky to be living in the Toronto area because at this time there is a lot of research going on in the city related to neuromodulation and. If I was in any other city, I would not have the opportunities that I have to receive these experimental surgeries.
So, let's look at the pros and cons of DBS and FUS.
Deep Brain Stimulation (DBS)
Pros:
- Surgical technique has been used for a number of years to help treat patients with Parkinson's disease and for the past several years on patients with depression, so it is a well understood procedure.
- Many patients have had this surgery done for depression and they have data tracking how well these patients have done for years. About a third go into complete remission, about a third do somewhat better and about a third don't have any improvement. It's important to remember with these numbers that the people who receive this surgery are the hard cases that have really serious depression that can't be cured by other means. Thus, these numbers are reasonable.
- If it doesn't work, or if there is a problem, then they can just turn it off and I will be back to the way I was before the surgery. If worse came to worse, and they had to, they could also remove all of the hardware from my body.
Cons:
- It is an invasive procedure where they drill a couple of holes in your skull, implant electrodes and then place a battery pack under the skin near your collarbone. That doesn't sound like a pleasant experience. Also, you are awake for the brain surgery, which is a little dis-concerning.
- My hairline is receding, so you will probably be able to see the scar from the surgery and the bumps from the caps that they place over the holes in your skull near the front of my head. I may become self-conscious of this.
Focused Ultrasound Surgery (FUS)
Pros:
- It's a scalpel-free surgery where they use an MRI machine to guide focused ultrasound waves at a particular part of the brain. The procedure is relatively simple and painless with not much recovery time needed.
Cons:
- They are making permanent lesions in your brain. If things don't work out well, there is no going back and changing something back.
- The procedure has only been done on a handful of patients (I was recently told only 5) in North America and there isn't really any data tracking how well these patients have done over a period of time.
Conclusion
For me the cons of FUS outweigh the pros. It is just too risky of a procedure. Even though DBS is more invasive, I prefer the track record of that procedure over FUS. Thus, given the option I would prefer to have DBS done. However, like I said, I may not have that choice and if I am only approved for FUS, I would go with that, despite the risk. I am in a situation where I need to try something.
