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Deep Brain Stimulation: Symptoms, Classification, Diagnosis & Recovery

Deep brain stimulation (DBS) is a neurosurgical procedure that involves the implantation of electrodes within the specific targeted areas of the brain. It is used to treat a variety of disabling neurological symptoms.

Deep brain stimulation procedures are used to treat several disorders, such as:

  • Parkinson's disease
  • Dystonia
  • Epilepsy
  • Tourette syndrome
  • Obsessive-compulsive disorder
  • Chronic Pain

Deep brain stimulation uses a neurostimulator, commonly referred to as a deep brain stimulator, to deliver electrical stimulation to targeted areas in the brain that control movement.

The impulse sent by the deep brain stimulator interferes with and blocks the electrical signals that cause tremors and other Parkinson’s disease symptoms. The targeted areas most often include the thalamus, subthalamic nucleus, and globus pallidus. Deep brain stimulation procedure has a long history of research. It was first introduced in 1987 and The Food and Drug Administration (FDA) approved deep brain stimulation treatment for essential tremor and Parkinson's disease in 1997.

A pacemaker-like device inserted under the skin in the upper chest regulates the amount of stimulation during deep brain stimulation. The electrodes in the brain are connected to this device by a wire that passes beneath the skin.

Deep brain stimulation treatment has proven effective in most cases, but it could potentially result in serious complications and side effects. This is the main reason why deep brain stimulation treatment is used only for patients whose symptoms are not appropriately controlled with medications.

The signs and symptoms related to DBS are more associated with the underlying neurological conditions it is designed to address rather than being inherent to the stimulation itself. Here are some signs and symptoms related to the neurological disorders often treated with DBS:

  • Parkinson's Disease: Involuntary shaking of hands, arms, legs, jaw, or head.
  • Bradykinesia: Slowness of movement.
  • Rigidity: Stiffness in the limbs and trunk.
  • Postural Instability: Impaired balance and coordination.
  • Essential Tremor: Trembling or shaking, particularly during purposeful movements.
  • Dystonia(Involuntary Muscle Contractions): Twisting or repetitive movements affecting various body parts.
  • Obsessive-Compulsive Disorder (OCD): Intrusive, unwanted thoughts or images.
  • Repetitive behaviors or mental acts are performed to alleviate anxiety.
  • Epilepsy: Abnormal electrical activity in the brain leading to convulsions, loss of consciousness, or altered behavior.

Deep Brain Stimulation (DBS) is a treatment primarily used for movement disorders such as Parkinson's disease, essential tremor, and dystonia. The decision to undergo DBS involves a comprehensive evaluation and diagnosis process. Here are key aspects of the diagnosis and testing for DBS treatment:

  • Comprehensive Neurological Evaluation: A thorough assessment by a neurologist or movement disorder specialist is conducted to evaluate the patient's medical history, symptoms, and overall health.
  • Confirmation of Diagnosis: The underlying movement disorder, such as Parkinson's disease or essential tremor, is confirmed through clinical examination and possibly additional diagnostic tests like imaging studies (MRI or CT scans).
  • Response to Medication: Patients are typically considered for DBS if their symptoms are not adequately controlled with medication or if they experience medication-related side effects.
  • Neuropsychological Evaluation: A neuropsychological assessment may be conducted to evaluate cognitive function, mood, and other factors that can impact the overall suitability for DBS.
  • Imaging Studies: High-resolution brain imaging, such as MRI or CT scans, is performed to visualize the structures within the brain and identify the optimal target for electrode placement.
  • Trial Stimulation (Microelectrode Recording): In some cases, a trial stimulation may be conducted during surgery using microelectrode recording to confirm the optimal placement of the electrodes and assess their impact on symptoms in real-time.

During the deep brain stimulation therapy, the neurosurgeon first uses an MRI or computed tomography CT scan to identify the exact target within the brain where electrical nerve signals generate the symptoms. Some doctors may use microelectrode recording (a small wire that observes the activity of nerve cells in the target area) to more specifically and precisely identify the target in the brain that will be stimulated during the treatment.

After identifying the targets in the brain, there are several ways in which the permanent electrodes are placed into the target areas. The patient is given a local anesthetic before the procedure, and then the neurosurgeon implants the electrode by making small holes in the skull. The implanted electrodes are connected with extensions (a thin insulated wire) connected with the stimulator. These extensions are passed by some incisions under the skin of the head, neck, and shoulder. A deep brain stimulator is a battery-operated medical device similar to a heart pacemaker. It is implanted under the skin near the collarbone or in the chest.

The surgeon schedules a time to program the generator a few weeks following surgery. The generator continuously pulses electricity into the brain once it has been programmed. With the help of a specialized remote control, the Patient may operate the generator and switch it on or off.

  • Typically, patients need to stay in the hospital until their incision-related pain is under control, and they can eat, drink and walk. Mostly, the patients are required to stay for only one night at the hospital after the surgery, but some patients may be advised to stay for at least two nights. The patient will not be able to shower or wet the area around the incision until the wound has completely healed.
  • Deep brain stimulation programming takes place about 3 to 4 weeks after the surgery and this is when the actual benefits of the treatment can be reaped.
  • After a few weeks of surgery, the neurostimulator (IPG) is activated by a specialist. The specialist can easily program the IPG from outside the patient’s body using a special remote control. The amount of stimulation is customized as per specific needs. Stimulation may be constant or the specialist may advise to turn the IPG off at night and back on in the morning, depending on the condition of the patient. The batteries of the stimulator may last for three to five years. The IPG replacement procedure is relatively simple. Inform your doctor immediately in case you experience any problems related to speech, balance, and coordination or in case you experience mood swings, numbness, muscle tightness, or lightheadedness.

Chloe from Australia underwent Deep Brain Stimulation Surgery in India
Chloe Diane Mii Tangaroa


Chloe Diane from Australia underwent Deep Brain Stimulation Surgery in India Read Full Story

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Frequently Asked Questions

Q: How helpful is deep brain stimulation for Parkinson’s disease?

A: Deep brain stimulation for Parkinson’s disease is not a cure, but it may help to control the symptoms associated with movement such as tremors, rigidity, stiffness, slowed movement and walking problems. As a result, the patient has to depend less on medications after deep brain stimulation treatment and evade the side effects of the medications such as dyskinesia. Deep brain stimulation can treat a majority of the major symptoms of Parkinson’s disease and it also improves the quality of life of the patient.

Q: What is the success rate of deep brain stimulation?

A: The success rate of deep brain stimulation procedure and DBS Parkinson's is quite good enough to be suggested to the patients, primarily when their quality of life is no more acceptable. If deep brain stimulation treatment works, the symptoms experienced by the patient improve significantly. But symptoms usually do not go away completely and this is the reason why in some cases, medications may still be needed.

Q: How long does it take to recovery from deep brain stimulation?

A: The actual DBS programming takes place at least three to four weeks after the surgery. This is the actual time that it takes for a patient to recover fully and getting used to the stimulator may take a few more days or weeks.