Deep brain stimulation (DBS) is based on the same technology used in cardiac pacemakers — it delivers carefully controlled electrical stimulation to precisely targeted areas of the brain that affects movement. The electrical charge interrupts or overrides the brain's faulty signals and, in conjunction with medication, reduces the rigidity, tremors, slow movement, and other symptoms of advanced movement disorders.

In general, you become a candidate for DBS if you:
  • Suffer from moderate to severe symptoms of Parkinson's Disease
  • Begin to experience difficulty or side effects with medication, but are still responsive
  • Have no indication of dementia
  • Are in overall good health

The procedure is both reversible and adjustable, making it a vast improvement over other surgeries. As a patient's disease progresses over time, the device can be reprogrammed accordingly to minimize new or increasing symptoms, or removed entirely. 

Procedure

Deep Brain Stimulation installation, activation, and programming are a three-part procedure, usually completed over the course of a month to six weeks. It carries no more risk than any other surgical procedure. For many patients, the mere placement of the electrodes is enough to produce immediate improvement. Others may not notice an appreciable difference in symptoms for several months.

Who are eligible candidates?

People suffering from Parkinson's disease (PD) who are not tolerating medical therapy or who cannot tolerate some of the side effects of the medications (Dyskinesia in particular) are eligible candidates for DBS.

Medical therapy is the first line of treatment in PD and thorough trial of medications and extensive follow-up with a neurologist is important before surgery can be considered.

Those people who have benefited from or responded well to levodopa or Sinemet therapy are better candidates.

Previous pallidotomy or thalamotomy does not exclude one from DBS. In fact, patients who have benefited from these procedures will most likely benefit from DBS.

All cardinal features of PD are treated with DBS. Freezing, stiffness, and tremor all show improvement with DBS in the subthalamic nucleus. Dyskinesias also show improvement as the amount of medication is decreased as the stimulator is adjusted.

Those with essential tremor (ET) who are growing "resistant" to the medication or who are suffering from medication side effects, are good candidates for thalamic DBS. Extensive work-up and medical therapy should always come before surgery for ET.

Other movement disorders, such as dystonia, tremor from stroke, or multiple sclerosis can also be treated after medical therapy has failed.

What if they find a cure with medicine?

It is both reversible and adjustable, making it a vast improvement over other surgeries. As a patient's disease progresses over time, the device can be reprogrammed accordingly to minimize new or increasing symptoms. The device can also be removed entirely to make way for newer treatments, improved techniques or a medical cure.

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Additional information

Parkinson's Foundation Center of Excellence

MedStar Health is on the forefront of research about Movement Disorders, Parkinson’s disease and Deep Brain Stimulation or DBS. Our comprehensive movement disorders program provides thorough evaluations, accurate diagnoses, and effective treatment options.