What Is Deep Brain Stimulation?
You might be reading this because you have one of the following conditions:
- Parkinson's
- Drug-resistant epilepsy
- Essential tremor
- Dystonia
- Treatment-resistant obsessive-compulsive disorder (OCD)
While not a cure for any disease, deep brain stimulation (DBS) can help control your symptoms for better physical and mental wellbeing.
Is Deep Brain Stimulation Right for You?
You may be a candidate for DBS if your meet the following criteria:
- You have troubling "off" periods when your Parkinson's medication wears off before the next dose can be taken.
- Your medications aren’t effectively managing your symptoms for essential tremor, epilepsy, or OCD.
- You are in good physical health.
If you’re considering DBS, it’s also important to have realistic expectations. The surgery requires frequent monitoring and doctor visits (at least initially). Patients should not expect a cure, but rather an improvement in symptoms or symptom control. Other key factors include good physical health, a solid support system, and realistic expectations for treatment outcomes.
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Deep Brain Stimulation Surgery
Deep brain stimulation surgery involves three components:
- A pacemaker-like device called a pulse generator
- Thin wires called leads or electrodes that enter the brain
- Wires called “lead extenders” that connect the electrodes in the brain to the pulse generator in the chest
Your surgeon will implant all three components inside your body. They will also use MRI technology to identify exactly which part or parts of your brain are causing your symptoms. This is where the electrodes will be targeted. You will most likely receive general anesthesia, which means you’ll be asleep throughout DBS surgery.
In the past, patients stayed awake during the procedure (which is possible because the brain has no pain receptors), but many were understandably too nervous to explain how the electrodes affected their speech and body movement. Now doctors can rely on imaging, rather than patient feedback, to understand what’s happening as they operate and to make sure the electrodes are in the right place.
Deep Brain Stimulation Risks
As with any surgical procedure, there are risks and potential complications:
- Infection (that can occur in four percent of patients implanted with a neuromodulation device)
- Bleeding
- Stroke caused by DBS electrodes
You could also experience temporary pain and swelling in the implantation site, seizure, headache, confusion and difficulty concentrating. The neurotransmitter could also break or malfunction, which would require another surgical operation.
DBS and Parkinson’s
For Parkinson’s, your surgeon will make a dime-sized incision in your skull to implant the leads directly into a deep part of your brain. If that makes you nervous, know that this is a highly established procedure that has only improved since the Food and Drug Administration first approved its treatment of movement disorders in 1997.
DBS and Essential Tremor
For essential tremor, DBS works similarly to DBS for Parkinson’s. However, your doctor might also recommend focused ultrasound—that is, using ultrasound sound waves to affect the same part of the brain but with no cuts or incisions.
DBS and Epilepsy
For epilepsy, doctors at the University of Utah target a different part of the brain than for Parkinson’s or essential tremor, called the anterior nucleus of the thalamus. This is effective at reducing the frequency of seizures and improving quality of life.
DBS Surgery Recovery Time
After surgery, most patients stay overnight at the hospital and return home the next day. Then, you’ll come back four to six weeks later to have your device programmed to deliver the right amount of electrical stimulation for you and your symptoms.
When everything is functioning properly, the pulse generator sends electrical impulses to the electrodes. These impulses interfere with and block the electrical signals that cause your symptoms.
DBS surgery isn’t a cure for movement disorders, epilepsy, or OCD, but it can give you a new lease on life.
Next Steps
If you would like to find out more information about DBS surgery, you will need to get a referral. You do this by seeing your primary care doctor or neurologist and requesting to see a neurosurgeon specializing in DBS.
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