Deep Brain Stimulation

Movement disorders like Parkinson’s disease and essential tremor make simple things like eating, writing or even walking harder. If medications and lifestyle changes don’t help you anymore, your health care provider may suggest deep brain stimulation (DBS).

DBS is a treatment that can help reduce symptoms and make your life easier. Learn how it works, the risks and benefits and whether it might be right for you.

What is deep brain stimulation?

DBS helps manage movement disorders and certain neuropsychiatric conditions when other treatments no longer work or cause side effects. It works by sending electrical signals to specific parts of the brain that control movement. 

A small pacemaker-like device called a neurostimulator or pulse generator is placed under the skin in the chest. It is connected to thin wires (called leads or electrodes) that go into your brain. 

DBS does not damage brain tissue or cure conditions but can help manage symptoms and make daily activities easier. It can help reduce symptoms such as tremors, stiffness and difficulty moving. For some people, DBS can also help reduce the amount of medication you may need.

Conditions treated by deep brain stimulation

DBS is FDA-approved to treat certain movement disorders, including:

• Parkinson’s disease: Causes shaking, stiffness, slow movement and balance problems
• Essential tremor: Causes uncontrollable shaking, often in the hands
• Dystonia: Causes muscles to contract involuntarily, leading to twisting or repetitive movements 
• Epilepsy: Causes uncontrolled Seizures

This procedure is also being studied for use in treating:

• Obsessive-compulsive disorder (OCD)
• Tourette syndrome
• Severe depression and anxiety
• Eating disorders
• Alzheimer’s disease
• Schizophrenia

How is deep brain stimulation done?

The DBS process usually involves a multidisciplinary team, including a neurosurgeon, neurologist, clinical neuropsychologist, speech pathologist and other specialists. It requires two or three surgeries, which usually happen at different times.

Before having DBS surgery, you’ll need medical tests to ensure it is safe and a good option. You may need brain imaging studies, like an MRI or CT scan, to help map out the areas of your brain where the electrodes should be placed.

The DBS surgery can be done under local anesthesia (numbing medicine), or general anesthesia (medicine to put you to sleep) depending on the brain target and what condition is being treated.

The procedure is done in three steps:

Step 1: Lead placement

You will be admitted to the hospital. Your hair is shaved only in the incision area (small cut). If you remain awake, you will be given a local anesthetic to numb your scalp before the procedure. 

A neurosurgeon will make an incision and use a surgical drill to create a small hole in your skull, about the size of a nickel. Then, they will place the leads (thin wires) into the brain. During surgery, you may be asked questions or asked to perform tasks, like moving your face, hand or arm, to ensure the electrodes are placed correctly.

You’ll recover in the hospital for one day until discharged. 

Step 2: Stimulator placement

About a week later, you’ll return for an outpatient procedure to place the neurostimulator device, which is about the size of a tea bag. You’ll be under general anesthesia but will go home the same day.

Your surgeon will make a small incision and place the small device just under your collarbone. They will connect the device to the leads inside your brain. The wires travel between the outside of your skull and the underside of your skin, so they are not visible.

Step 3: Programming the device

Your health care team will schedule a follow-up appointment a few weeks later to adjust the device settings to find the right level of stimulation. The device has a wireless antenna, so it can be adjusted without surgery. It also has special batteries with long lifespans, some last up to twenty years with recharging. 

Benefits of deep brain stimulation

DBS does not cure neurological conditions, but it can help reduce symptoms. Some of the benefits include:

• Better movement control: Reduce tremors, stiffness and difficulty walking
• Less medication: May lower medication doses, which helps reduce side effects
• Improved quality of life: Make daily activities like eating, writing and dressing easier
• Adjustable treatment: Settings can be fine-tuned to meet your needs over time
• Reversible: Leads and the pulse generator can be removed if DBS doesn’t work or causes side effects

For many people, DBS helps them do more things and feel more independent.

Risks and considerations

Like any surgery, DBS has some risks. These include:

• Surgical problems: Bleeding, infection or complications from anesthesia
• Device issues: The neurostimulator may need adjustments or replacement over time
• Side effects: Some people experience tingling, speech problems or mood changes, but these can be adjusted

Your health care team will talk to you about these risks and help you decide if DBS is right for you.

Life after deep brain stimulation

Once you’ve healed, you can get back to regular activities like swimming, traveling and sexual activity. Most people notice improvements in their symptoms within weeks of DBS. However, it can take some time to adjust the settings for the best results. You will have follow-up visits with your provider to make sure the device is working correctly.

While DBS may allow you to reduce medication doses, it does not stop disease progression. You will still need to manage your condition with regular medical care.

Is DBS right for you?

If you or a loved one is struggling with Parkinson’s disease or another movement disorder, deep brain stimulation may be an option. Contact Banner Health to schedule a consultation and learn more about how DBS can help you take back control of your life.