Deep Brain Stimulation
Deep brain stimulation (DBS) is a minimally invasive surgical treatment for a variety of diseases, including Parkinson's disease, essential tremor, dystonia and obsessive compulsive disorder. DBS involves a neurosurgeon implanting electrodes (small wires) in a targeted area of the brain. The electrodes are connected to a neurostimulator, which works like a pacemaker for the brain and delivers precise doses of electricity to stimulate the brain.
Who is a Candidate for DBS?
Before having DBS, a patient must be evaluated by a medical professional to determine if it will be a safe and effective treatment option for their condition.
You may be an ideal candidate for DBS if:
- Medications have not been able to control your symptoms.
- You are cognitively healthy, meaning that you do not have dementia or other significant memory problems.
- You do not have a serious heart or lung problem or other chronic illness that makes surgery too risky.
How to Prepare for Surgery
If you’re a candidate for DBS, you can count on a dedicated team of experts to be with you every step of the way. Before your surgery, which includes two separate procedures, it's important that you meet with your neurosurgery care team. They’ll let you know what to expect during surgery, during your stay in the hospital and recovery. Use this brief checklist to help you prepare for your surgery date:
- Bring all medications, vitamins, minerals or other supplements you take and their exact dosages to your pre-operative appointment.
- Discuss with your neurosurgeon whether you should stop taking blood-thinning medication such as aspirin, Plavix, indomethacin or warfarin, and, if so, when.
- Be sure to follow all instructions from your care team, including making sure not to eat or drink anything—including water—starting at midnight before your surgery.
What to Expect During Surgery
First Procedure: Placing the Wires
You’ll be fitted with a head frame and undergo an imaging scan, which guides the surgeon on where to place the wires. During the surgery, some patients are asleep and others are kept awake so the placement of the leads can be fine-tuned. After surgery, you will typically be allowed to go home the next day. If your neurosurgeon and neurologist decide that two wires (one on each side) are better for your case, then you will return the following week for another surgery to place the second wire.
Second Procedure: Placing the Neurostimulator
Three to five days after your first procedure, you will come back in a second procedure to have the neurostimulator (brain battery pack) installed just below your collarbone and attached to the wires that were placed during the first procedure. The anesthesiologist will put you to sleep for this surgery. This procedure is usually performed on an outpatient basis, and you will go home the same day.
What to Expect During DBS Treatment
You can normally start treatment with DBS about three to four weeks after the system has been implanted. Treatment can last 1-2 hours. Here's what to expect:
- Your programming neurologist will check the battery pack and wires to make sure they're working properly.
- The device will be programmed through multiple settings to determine which settings will work best for you.
- You'll be asked to take your medications during this visit to see if the stimulation has an effect on your medication.
- If necessary, your medication will be adjusted.
- More follow-up visits may be needed until the right settings are found.
- Once the right settings are found, your visits move to once every few months.
Talk to your doctor about your options to see if DBS or alternative surgical treatment options are right for you.
This information is provided for patient use and is intended only as a general overview for this procedure. Any questions or concerns should be discussed directly with your physician.