Deep Brain Stimulation (DBS) is a surgical procedure in which electrodes are placed in a specific region of the brain. The region varies depending on the disease being treated.The procedure is FDA-approved for Parkinson’s Disease, Essential Tremor, dystonia, and Obsessive-compulsive disorder. It is under investigation for a number of other diseases including epilepsy and major depression.
DBS can provide excellent symptomatic relief for the right candidates. Results often depend on patient management prior to, during, and following the operation. Therefore, it is important to have DBS performed at a center that is well-versed in the team approach to the patient, like Albany Medical Center’s Neurosciences Institute.
Because of the complex nature of the procedure and follow-up, it is important for candidates to have a strong support group, including family, friends, other patients who have gone through the process, and your health care providers.
Process of becoming a candidate
There are many steps to take in order to become a candidate for DBS and because it can take an extended amount of time, there is no reason to hurry through the process. In order to become a candidate, you must see a variety of specialists, including a movement disorders neurologist, a neuropsychologist, and a neurosurgeon.
Testing includes an objective evaluation of your symptoms and overall health. The neuropsychological battery assesses your judgment, emotional and cognitive function, and support system compared to other adults your age. A special MRI with high resolution must be performed.
What symptoms will respond?
This varies depending on the disease being treated. Parkinson symptoms that will respond to DBS include:
- Slowness of movement
- Fluctuations in how you respond to medications
- Other symptoms that medications treat
What symptoms will not respond?
- Walking (unless it improves with medication)
- Fatigue (unless caused by medication)
- Gastrointestinal issues (unless caused by medication)
Side effects of DBS
Comparable groups of patients who meet certain criteria do significantly better with DBS than with medication. There is the possibility for more serious side effects with surgery, but medications can cause side effects as well. It is necessary to make sure medications are no longer giving adequate relief before undergoing DBS. Deep Brain Stimulation may also cause changes in emotions and in tests of cognitive function. Our team of experts will work with you to make sure you are followed closely and treated appropriately should side effects develop.
Good candidates are individuals who are medically fit for surgery. Poor candidates can include individuals with untreated psychiatric illnesses, cognitive impairments, progressive lack of judgment, and/or unrealistic goals and expectations. Please be aware that DBS treats symptoms but does not cure the disease.
Deep Brain Stimulation surgery is generally performed in two separate procedures. The first procedure is in order to place brain leads. Then on a separate day, another procedure is performed in order to place batteries. Following both surgeries, patients generally go home the next day.
Dos and Don’ts before surgery
You should wait a week or two after recovering from a cold or illness to have surgery. If you have any infections, surgery should be postponed until after infections have cleared. You must stop taking blood thinners and aspirin 7 to 10 days before surgery. Discontinue use of Motrin, Aleve, fish oil and vitamin E because they pose bleeding risks. Keep taking your major medications.
For more in depth information about DBS, procedures, preparation and post operative care, you can watch this video of Dr. Julie Pilitsis.