Deep Brain Stimulation

Deep Brain Stimulation (DBS) is a neurosurgical treatment involving the implantation of a fine electrode wire and pulse generator which stimulates the brain with mild electrical signals. The signals reorganize the brain’s electrical impulses, causing significant improvements for otherwise treatment-resistant movement disorders, such as Parkinson’s disease, essential tremor and dystonia.

Approved by the U.S. Food and Drug Administration in 1997, DBS can dramatically change the lives of patients with uncontrollable tremors. Oftentimes, patients feel they have been “given their life back” because they are able to resume normal daily activities and anti-tremor medications can be reduced. The Parkinson’s Disease Foundation states that worldwide, about 75,000 patients have had DBS treatments.

The DBS Treatment Process

Deep brain stimulation is a multi-stage process that requires a commitment to ongoing follow-up care. The phases and timing will vary for each unique situation, but a typical process will include the following steps:

Stage 1 – Screening and Evaluation

  • A DBS-coordinating neurologist, along with a neurosurgeon, physical therapist and neuropsychologist, will perform a comprehensive evaluation and screening on the potential DBS patient to determine if he or she is a good candidate for deep brain stimulation.

Stage 2 – Pre-surgical Planning and Mapping

  • One week prior to surgery, the patient will have four to five small fiducial markers placed in the skull.
  • An MRI and/or CT image is obtained.
  • Coordinates are determined for placement of the fine electrode wire, and a safe trajectory down to the target is identified.

Stage 3 – Implant DBS Leads

  • The surgical procedure is performed under local anesthesia, and the patient remains awake.
  • One or two small holes, the size of a dime, are drilled into the skull.
  • Micro-electrodes are first passed into the brain through these small holes to record brain activity and identify the best location for the DBS lead.
  • The final electrode is placed and turned on temporarily, and clinical effect is tested.
  • Requires overnight hospital stay.

Stage 4 – Implant Neuro-Stimulator

  • An MRI is obtained to assess lead placement.
  • Two to three weeks later, a generator is placed in the chest under the clavicle and connected to the electrode in the head.

Stage 5 – Programming and Tuning

  • After DBS treatment, the patient will have a lifelong relationship with his or her coordinating neurologist.
  • The patient will be seen by the coordinating neurologist for the initial “programming” of the deep brain stimulator.
  • Periodically, the coordinating neurologist will perform noninvasive “tuning” of the stimulator to ensure optimal control and management of disease symptoms.

For information about treatments and procedures, please call (770) 219-6520 or submit a contact form.