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What Is Deep Brain Stimulation (DBS)

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

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Overview of Deep Brain Stimulation (DBS)

Deep brain stimulation (DBS) is a neurosurgical procedure. DBS uses implanted electrodes along with electrical stimulation to treat that regulate abnormal impulses. DBS is used to treat movement disorders, which are usually associated with Parkinson’s disease (PD), essential tremor, dystonia and some other neurological conditions.

Deep Brain Stimulation

Deep Brain Stimulation

How Patients Are Chosen for DBS

There is an extensive evaluation process when deciding if a patient needs DBS. Typically the evaluation requires a multidisciplinary team of specialists, which includes a neuropsychologist, neurologist, neurosurgeon and a psychiatrist. Patients that can be managed with medication are not considered for DBS.

Patients that are considered for DBS meet the following criteria:

  • Their symptoms are not controlled with medications.
  • The patient’s symptoms are reducing their quality of life.
  • The patient is having side effects with their current medications.

DBS Treatment

Deep brain stimulation is a three part procedure. First, electrodes are implanted in the brain. Then, the deep brain stimulation is controlled using a pacemaker-like device that is implanted under the skin in the upper chest, which is implanted on another day. A wire then runs under the skin connecting the device to the brain electrodes while the patient is asleep.

The amount of stimulation in deep brain stimulation is controlled by a pacemaker-like device placed under the skin in your upper chest. An implantable pulse generator (IPG) that travels under your skin connects this device to the electrodes in your brain. The third step of this procedure is setting up the generator.

If there are unwanted side effects with DBS or if a more promising treatment is developed the implantable pulse generator (IPG) can be removed, thus halting the DBS treatment. The IPG can also be easily adjusted, which does not require further surgery.

The videos below explain deep brain stimulation very well.

Deep Brain Stimulation (DBS): Stages of Surgery

Treatable Medical Conditions

The Food and Drug Administration is approved for several neurological and movement disorders. Several medical conditions are being evaluated as well. The most common conditions treated using DBS include:

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  • Parkinson’s Disease
  • Dystonia
  • Essential tremor
  • Epilepsy
  • Obsessive compulsive disorder

There are several medical conditions that are being studied using DBS as a treatment, and they include:

  • Huntington’s Disease
  • Multiple sclerosis
  • Cluster headaches
  • Tourette syndrome
  • Chronic pain
  • Traumatic brain injury
  • Depression
  • Stroke recovery
  • Thalamic pain syndrome
  • Alzheimer’s disease
  • Anorexia nervosa
  • Addiction

The National Institute of Neurological Disorders and Stroke (NINDS)’s mission is to seek knowledge concerning the brain and nervous system, thus looking for treatments. Mayo Clinic currently has thirty DBS studies that are ongoing.

Insertion of electrode during surgery using a stereotactic frame

Insertion of electrode during surgery using a stereotactic frame

Prognosis

Every surgical procedure carries some risk. Most people are able to return to work after one or two weeks, but there is still a low risk of bleeding or infection in the brain. Other possible complications include swelling of brain tissue causing headaches, some temporary pain or seizures.

Most of the patients continue taking some medication after DBS. Patients with Parkinson’s disease will typically find a considerable reduction in their motor symptoms with a reduction in their medications.

Patients with dystonia may find they respond more favorably to DBS than to medications. As DBS can target the thalamus gland reducing involuntary movements of the hands, arms and head associated with essential tremor. Patients with epilepsy will usually find a reduction in the number of seizures over time.

DBS is not typically used for dementia as it does not improve cognitive symptoms and can even worsen them. While DBS changes the brain firing pattern it does not reduce the progression of any neurodegeneration.

Deep Brain Stimulation for Parkinson’s, Tourette’s

Final Thoughts

Scientists have learned a large amount of information about the brain over the last fifteen years, and deep brain stimulation has certainly advanced. For instance, Parkinson’s disease can make a person’s life miserable as it progresses, but with DBS the individual has a chance at a somewhat normal life. The vast amount of research will ultimately help many patients with a variety of medical conditions affecting the nervous system.

References

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2022 Pamela Oglesby

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