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Deep Brain Stimulation Therapy

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what receiving deep brain stimulation can involve.

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Find answers to your questions about deep brain stimulation.

Understanding Deep Brain Stimulation Therapy

Deep brain stimulation (DBS) is a therapeutic treatment that helps to reduce symptoms of movement disorders by blocking electrical signals from targeted areas in the brain that cause involuntary movements.

The symptoms most commonly affected, or reduced, by DBS therapy include:

  • Tremor
  • Stiffness
  • Slowed movement
  • Medication complications
  • Gait changes1

How deep brain stimulation works

DBS therapy works by blocking electrical signals from targeted areas of the brain that cause involuntary movements. While it is not completely understood, it is thought that the stimulation helps to restore normal brain communication or “signaling” by delivering mild electrical pulses to specific areas of the brain.1

 

DBS system components

The DBS System includes three separate components that work together to provide effective therapy:

  • Implantable pulse generator (IPG)
  • Leads
  • Programmer

Implantable Pulse Generator (IPG)

The IPG is a small device that sends signals to the brain to help control movement. The IPG is placed in the chest area or abdomen. Once it is turned on, it is programmed to settings that provide the best therapy for your condition.

Leads

The leads are thin wires that carry the signals, or impulses, from the IPG to the brain. The lead is connected to the IPG on one end, and the lead’s tip is placed in an area of your brain that will best help control your symptoms. If you have symptoms on one side of your body, the lead is placed on the opposite side of your brain, as each side of the brain controls the opposite side of the body. Sometimes to best control symptoms, two leads are placed, each on one side of the brain.

Programmer

With DBS therapy, you have the control to turn your therapy off and on, or to adjust settings—within limits set by your doctor.

Benefits of DBS

Patients who are good candidates and have chosen DBS therapy have not only experienced improvements in their daily activities, but also in their mood and quality of sleep2—giving them a better quality of life.

While each person’s experience is different, both patients and caregivers have noted that symptoms for many patients have been reduced significantly, allowing a more normal, active lifestyle.3 Studies show that this improvement in quality of life can be sustained for up to 10 years and beyond.2,4 With an increase in activity and ability, and a reduction in noticeable symptoms, many patients feel more confident5 when interacting in their environments—giving them greater freedom to live the lives they want.

Risks of DBS

As with any surgery, there may be some risks or complications with DBS therapy. Most effects of DBS surgery are temporary and correct themselves within 30 to 90 days. Some, however, may be more serious and/or permanent. Talk with your doctor about the risks associated with the placement and use of a DBS system.

Risks of brain surgery may include serious complications, such as:

  • Coma
  • Bleeding inside the brain
  • Paralysis
  • Seizures
  • Infection

Some of these may be fatal. However, in a study of 1,183 patients, the risk of death within the first 30 days after implantation surgery was less than one percent.6 

Once implanted, the area around the system may become infected, parts may wear through your skin and the lead or lead/extension connector may move. Any of these situations may require additional surgery or cause your symptoms to return.

While most complications will have no after-effects, some people may experience lasting, stroke-like symptoms, such as weakness, numbness and problems with vision or slurred speech. In the event that side effects are intolerable or you are not satisfied with the therapy, the DBS system can be turned off or surgically removed.

Is DBS therapy right for you?

No two people are alike. Your experience with a movement disorder is unique, and many things can impact your response to DBS therapy.

If medication or other therapies are not providing adequate relief from your symptoms and you are looking for an alternative, talk to your doctor to see if DBS therapy is an option for you.

REFERENCES

1. Yu, H., & Neimat, J. (2008). The treatment of movement disorders by deep brain stimulation. Neurotherapeutics, 5, 26-36. http://dx.doi.org/10.1016/j.nurt.2007.10.072
2. Lyons, K. E., & Pahwa, R. (2006). Effects of bilateral subthalamic nucleus stimulation on sleep, daytime sleepiness, and early morning dystonia in patients with Parkinson disease. Journal of Neurosurgery, 104(4), 502-505. n=43. http://dx.doi.org/10.3171/jns.2006.104.4.502
3. St. Jude Medical. (2015). C-06-04 Interim Report. 
4. Castrioto, A. (2011). Ten-Year Outcome of Subthalamic Stimulation in Parkinson Disease. Archives of Neurology, 68(12), 1550. n=18. http://dx.doi.org/10.1001/archneurol.2011.182
5. Baizabal-Carvallo, J. F., & Kagnoff, M. N. (2013). The safety and efficacy of thalamic deep brain stimulation in essential tremor: 10 years and beyond. Journal of Neurology, Neurosurgery & Psychiatry, 85(5), 567-572. n=13. http://dx.doi.org/10.1136/jnnp-2013-304943
6. Voges, J., Hilker, R., Bötzel, K., Kiening, K. L., Kloss, M., Kupsch, A., ... Pinsker, M. O. (2007). Thirty days complication rate following surgery performed for deep-brain-stimulation. Movement Disorders, 22(10), 1486-1489. http://dx.doi.org/10.1002/mds.21481