Deep brain stimulation (DBS)
Deep brain stimulation (DBS) is a multi-step neurosurgical procedure that uses electrical impulses to stimulate a target area in the brain. These impulses affect movement of the limbs by altering the activity in a specific area of the brain.
Deep brain stimulation may be used to relieve symptoms of Parkinson's disease that cannot be controlled with medicine. DBS is considered the surgical treatment of choice for Parkinson's disease because it is highly effective, safer and less invasive than other surgical methods.
At MU Health Care, a multidisciplinary team of expert neurologists, neurosurgeons, neurocognitive specialists and expert nurses will care for you throughout your DBS treatment. Our dedication to compassionate, patient-centered care as well as our combined 40 years of experience provide patients with all the benefits of a major medical center in a convenient location.
Conditions that might benefit from the procedure
In addition to treating patients with Parkinson’s disease, DBS can be used to treat patients with certain types of dystonia or those with essential tremor.
In addition to helping control tremors, DBS also can help with changes between "on" and "off" time and dyskinesia, frequent complications seen in advanced Parkinson’s disease. Symptoms that are less likely to improve with DBS include problems with walking, balance and speech.
Am I a candidate?
Even though DBS can be an effective way to relive symptoms of Parkinson's disease, dystonia and essential tremors, not everyone is a candidate for surgery. At MU Health Care, you’ll work with a multidisciplinary team to determine if DBS is an appropriate treatment for you.
First, you’ll meet with a neurologist who will measure the potential impact DBS would have on your cognition and mental health. If the tests are favorable, you’ll meet with the neurosurgical team that will assess whether you are a candidate for surgery. If so, the neurosurgical team will schedule the procedure.
DBS surgery is done in two phases. The first phase is when the wiring equipment is installed. The second phase is when the wires are connected to the battery, or pulse generator.
During the first phase, the neurosurgeon places electrical stimulation equipment into your brain through a small hole in the skull. The surgeon will place a tiny wire with electrodes in the location that most benefits you. This initial surgery takes approximately three to five hours.
During the second phase, the surgeon implants a small battery-powered device similar to a pacemaker into your chest and connects it to the electrodes in your brain. The wiring and the battery device, or pulse generator, are placed underneath the skin (the wires are not visible). The second surgery usually takes two to three hours and is typically done two weeks after the first surgery.
A few days after surgery, you will return to your neurologist for programming. This visit can last anywhere from four to six hours. To provide the highest level of care, your doctor will personally fine-tune your device so that it delivers the correct level of stimulation to your brain so you have the greatest relief of symptoms.
After programming, your physician will schedule follow-up visits as needed – first weekly, then monthly, then every few months.
The risks associated with DBS are similar to most surgical procedures and may include:
- Infection or skin irritation caused by the device in the chest or by the wires or electrodes.
- Numbness, tingling, twitching or other abnormal sensations when the device is turned on. These sensations usually do not last long and can be eliminated by adjusting the programming of the deep brain stimulation device.
- Psychological problems, such as apathy and depression.
- Problems with thinking, memory, speech or swallowing.
- Difficulty with walking or balance and an increased risk of falling.
- Bleeding in the brain and stroke.
DBS requires minimal care, and your doctor will recommend avoiding activities that could place stress on the DBS. Some of these include sudden, excessive or repetitive bending, twisting or stretching.
Walking through some metal detectors or security gates, like those at airports and department stores, may increase the stimulation or turn off your DBS. Before walking through a security gate, make sure to show your DBS identification card to security and request a hand search. If a security wand is used, ask the security to avoid placing it over your battery.
Most household appliances and electronic devices that work well and are properly grounded will not interfere with your DBS.
Your doctor will also give you a programming device that you can use to control the DBS, and your provider will show you how to use it.