DBS

What is deep brain stimulation?

Deep brain stimulation (DBS) is a neurosurgical procedure that uses implanted electrodes and electrical stimulation to treat movement disorders associated with Parkinson’s disease (PD), essential tremor, dystonia, and other neurological conditions.

Doctors may use DBS for movement disorders or neuropsychiatric conditions when medications have become less effective or if their side effects interfere with a person’s daily activities.

Movement-related symptoms of Parkinson’s disease and other neurological conditions are caused by disorganized electrical signals in the areas of the brain that control movement. When successful, DBS interrupts the periodic signals that cause tremors and other movement symptoms.

After a series of tests determining the optimal placement, neurosurgeons implant one or more wires, called “leads,” inside the brain. The leads are connected with an insulated wire extension to a very small neurostimulator (electrical generator) implanted under the person’s collarbone, similar to a heart pacemaker. Continuous pulses of electric current from the neurostimulator pass through the leads and into the brain.

A few weeks after the neurostimulator has been in place, the doctor programs it to deliver an electrical signal. This programming process may take more than one visit over a period of weeks or months to ensure the current is properly adjusted and provides effective results. In adjusting the device, the doctor seeks an optimal balance between improving symptom control and limiting side effects.

Who is a candidate for deep brain stimulation? 

DBS is more than just a surgical procedure. It involves a series of evaluations, procedures, and consultations before and after the actual operation, so people interested in being treated with DBS should be prepared to commit time to the process.

For example, those who do not live close to a medical center that offers DBS surgery may need to spend significant time traveling back and forth to appointments.

The procedure, as well as the pre-operative evaluation and post-operative follow-up, can be expensive depending on the person’s insurance coverage. DBS surgery is an FDA-approved treatment for Parkinson’s disease, and Medicare and most private insurers cover the procedure, but the extent of coverage will depend on each person’s individual policy. 

Prospective patients should have realistic expectations about DBS results. Although DBS can improve movement symptoms of Parkinson’s disease and greatly improve quality of life in properly selected patients, it is not likely to return anyone to perfect health.