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Deep Brain Stimulation

Deep brain stimulation (DBS) is a surgical procedure used to treat a variety of disabling neurological symptoms—most commonly the debilitating symptoms of Parkinson’s disease (PD), such as tremor, rigidity, stiffness, slowed movement, and walking problems.  The procedure is also used to treat essential tremor, dystonia and some other movement disorders.  The procedure is used only for patients whose symptoms cannot be adequately controlled with medications.

Deep brain stimulation, or DBS, uses tiny electrodes surgically implanted into part of the brain.  The electrodes are connected by a wire under the skin to a small electrical device called a pulse generator that is implanted in the chest below the collarbone.  The pulse generator and electrodes painlessly stimulate the brain in a way that helps to stop many of the symptoms of PD or other movement disorder.  DBS is stereotactic surgery, meaning it uses a 3D coordinate mapping system to locate tiny areas in our bodies in order to perform surgery accurately.

DBS usually reduces the need for levodopa and related drugs, which in turn decreases dyskinesias.  It also helps to relieve on-off fluctuation of symptoms.  People who initially responded well to treatment with levodopa tend to respond well to DBS.  While the benefits of DBS can be substantial, it usually does not help with speech problems, anxiety, depression, or dementia.

DBS is not a good solution for everyone.  It is generally used only in people with advanced, levodopa-responsive Parkinsons Disease who have developed dyskinesias or other disabling "off" symptoms despite drug therapy.

Deep Brain Stimulation surgery may be performed on one or both sides of the brain depending on the patient and their symptoms.

Prior to surgery the patient is sedated and with the use of local anesthetic, a rigid stereotactic frame is placed around the skull.  A stereotactic MRI scan is taken to identify and locate the exact target within the brain where electrical nerve signals generate the PD symptoms. The target area is mapped with coordinates on a computer.

Deep Brain Stimulation surgery is performed by a Neurosurgeon under sterile conditions in an operating room with the patient initially awake but sedated.  General anesthesia is administered to finish the surgery once the electrodes have been placed in the brain.

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