Minneapolis VA performs new brain surgery

The Minneapolis VA neurosurgical team prepares for its first deep brain stimulation (DBS) surgery on a veteran in November. It also is the first in the VA Midwest Health Care Network (VISN 23). The Minnesota VA has funding for the procedure through a VISN 23 strategic initiative.

There aren’t many other places to get it

MINNEAPOLIS — The Minneapolis VA Health Care System is now among the few hospitals able to offer deep brain stimulation surgery.

“There was a big hole in our country,” said VA staff neurosurgeon Robert McGovern. “Until now, you had to go to the coasts.”

The Minneapolis VA performed its first deep brain implantation surgery on Nov. 24. McGovern also works at the University of Minnesota. The surgery is offered at either location.

DBS surgery involves implanting an electrode in a specific location within the brain in an effort to reduce tremors.

Through a prior MRI, the doctor has a map of the brain complete with coordinates. Just like in real life, McGovern said, a map is not the same as being there.

The patient is sedated. A hole the size of a quarter is drilled, then hair-wide electrodes that can reach individual brain cells are inserted, he said. That tells medical professionals specifically where in the brain they are.

The patient is woken up — you read that right — then asked to move parts of the body, which tells the surgeon where in the brain the electrode is. Then the surgeon inserts the final electrode and tests it to make sure the stimulation works.

The patient returns the following week, McGovern said, to make sure there are no side effects and to hook it to a wire that leads to a battery in the chest. That battery sends pulses.

“It’s kind of like a brain pacemaker,” he said.

The surgery is well-established for treating Parkinson’s disease and can treat essential tremor and dystonia. Previously, veterans from the Midwest had to travel to the San Francisco VA to even be considered for the surgery.

Why Minneapolis? McGovern said 1. only so many neurosurgeons do DBS and 2. the Minneapolis VA already has a strong team in place. McGovern went to Columbia University in New York and was hired by the VA in August 2018.

He said the stimulation works like a reversable lesion. Unlike a lesion, you can take it out.

“It works by resetting the electrical activity of the brain, the network of it,” he said.

How does stimulating a spot in the brain halt or reduce tremors? It’s unknown for certain, McGovern said, but the success of DBS in the treatment of Parkinson’s and other similar diseases is evident.

To learn more about the Parkinson’s Disease and Movement Disorders Program at Minneapolis VA, request a referral to Neurology through your primary care provider. If already established with Neurology but not Physical Medicine and Rehabilitation, request a referral from your neurologist.

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