Deep brain stimulation (DBS)
What is deep brain stimulation (DBS)?
DBS is a procedure in which tiny electrodes are placed into the brain with the help of computer guidance. These electrodes are connected to a small pulse generator implanted beneath the collarbone, much like a cardiac pacemaker. Continuous electrical stimulation effectively jams or blocks the abnormal circuitry of the brain that occurs with movement disorders, which results in an improvement of many of the most disabling symptoms, leading to an improved quality of life for patients suffering from these diseases.
People with Parkinson’s disease will see an immediate improvement with tremor, rigidity, slowness, motor fluctuations and involuntary movements, known as dyskinesia, as a result of medication. DBS improves Parkinson’s symptoms much like medicine does, so a significant reduction of medication can be expected.
Patients with essential tremor, who have a reduced quality of life due to their condition, will experience a significant reduction of hand tremors and may even be tremor-free. DBS will also substantially alleviate head and voice tremors in those who suffer from them. Long-term studies show that essential tremor remains responsive to DBS for years after surgery.
People with certain types of dystonia—including generalized dystonia, cervical dystonia, tardive dystonia and Meige syndrome—who undergo DBS will experience a life-changing improvement in their involuntary movements, allowing them to live a higher quality life.
At the Parkinson’s and Movement Disorders Center, we recognize the severity of Parkinson’s disease, essential tremor and dystonia and the challenges patients, their families and caregivers face with these disorders. We are here to help—no matter what your unique needs are.
If you still experience symptoms of your movement disorder despite the optimal medication and therapy treatment plan, we offer deep brain stimulation surgery as an option. Our team understands that the idea of surgery can be scary, and we are here to guide both you and your loved ones through every step of the process. Our team of specialty-trained neurologists, neurosurgeons, nurse practitioners, nurses, neuropsychologists and social workers are all dedicated to providing patient-centric, family-centered care. And the care offered at our Center goes beyond an outpatient office visit or a procedure—we are always available to answer questions, both before and after surgery, and our ultimate goal is to help you lead a happy, active and satisfying life.
Who it’s for
You may be a candidate for deep brain stimulation if you suffer from certain movement disorders such as Parkinson’s disease, essential tremor or certain types of dystonia, and are experiencing a reduced quality of life because you are not fully responding to medication.
When our Center assesses a patient to determine if they are a candidate for DBS, they are treated as an individual and work with an interdisciplinary team that includes specialty-trained movement disorders neurologists, functional neurosurgeons who have special training in DBS, and neuropsychologists. As part of your assessment, your neurologist will perform a comprehensive evaluation to determine medication response and a neuropsychologist will conduct a neuropsychological exam. Since collaboration and patient- and family-centric care are the cornerstones of our Center, you and any family members or loved ones involved in your care will understand each step of the evaluation process. You’ll discuss your care plan with the clinical team to determine the treatment that is right for you.
What to expect
In stage one of DBS, electrodes are implanted in the brain through a small incision. During the procedure, high-resolution imaging is used to locate the exact place where the electrode needs to be placed. This typically requires just a one-night hospital stay.
Stage two of the surgery is performed by the same functional neurosurgeon two to four weeks after the stage one procedure. Stage two involves the placement of the pulse generators and is done as an outpatient procedure in the hospital.
Four to six weeks after stage one, the stimulator is turned on and programmed by the movement disorders neurologist or specially trained nurse practitioner. This is done in the neurologist’s office as an outpatient visit. As every patient responds differently to stimulation adjustments, the postsurgical programming is just as important as the procedure itself. In patients with Parkinson’s and dystonia, it typically takes three to six months to achieve optimal stimulation settings. Patients with essential tremor may reach their optimal stimulation setting in just one or two office visits.
Deep brain stimulation is one component of ongoing treatment, and optimal results will be achieved when the ideal medical and rehabilitative care is incorporated.