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Deep Brain Stimulation

Deep brain stimulation (DBS) is a surgical approach that can be effective in controlling some of the debilitating symptoms of the following movement disorders:

For some people, DBS is effective in controlling these motor symptoms:

  • Tremor
  • Rigidity
  • Stiffness
  • Slowed movement
  • Walking problems

DBS does not help improve the cognitive and emotional symptoms of Parkinson’s disease, such as depression or memory loss. In fact, it can make these symptoms worse.

That’s why specialists in the movement disorders surgical program at Rush will do a thorough physical, neurological and neuropsychological evaluation to determine if DBS is the best option for you.

Can you benefit from DBS?

Medications help most people with Parkinson’s disease and other movement disorders symptoms find adequate relief from their motor symptoms.

However, DBS may help if you have Parkinson’s disease and are suffering through fluctuations in your symptoms throughout the day — experiencing periods of feeling and moving relatively well and periods of being unable to move independently.

DBS can be extremely effective in helping to decrease these ups and downs — and improve your quality of life — by providing a longer, more consistent period of moving and feeling better.

DBS can also effectively control tremor if you have essential tremor or dystonia (with dystonic twisting movement).

Your reaction to medications

One of the main predictors of whether or not DBS will be effective for your Parkinson’s disease is how well your medications control your symptoms.

You may be a good candidate for DBS if you have these characteristics:

  • Have a good response to your medicine, but it is not maintained throughout the day.
  • Are taking a complicated medication schedule, but you still have periods of the day when your medications do not work.
  • Have trouble walking, but you walk well when your medicines are working.
  • Are experiencing significant and damaging side effects from your medications.

Your overall health

Your overall physical and mental health also indicates if DBS will be effective for you.

You may be a good candidate for DBS if you have these characteristics:

  • Are under 75.
  • Are in good physical health otherwise.
  • Are not cognitively impaired (e.g., memory loss, dementia, hallucinations).
  • Do not have any late-stage Parkinson’s complications, including incontinence or falling when your medications are working.
  • Do not have depression.

Deep brain stimulation: How it works

  • DBS uses a neurostimulator in your brain to deliver electric signals to areas of the brain that allow for more consistent movement control.
  • If you have Parkinson’s disease, the stimulation reproduces the effect of dopamine on your movement symptoms, but does not itself cause release of dopamine.
  • The constant stimulation helps lessen the intense fluctuations that you may be experiencing with dopamine medications.
  • In patients with other movement disorders, the stimulation of brain targets help to lessen tremor or dystonia, allowing more normal movement.

The surgery

Stage 1: Determining where to place the stimulator

You will be awake, but under local anesthesia. During this stage, your surgeon will do the following:

  • Drill small openings in your skull and place a small wire in your brain (the lead).
  • Test the lead to make sure it is connected to the area of your brain causing your symptoms.
  • Conduct neurological tests to determine the safest place for the stimulator.

Stage 2: Placing the stimulator

You will be asleep under general anesthesia. During this stage, your surgeon will do the following:

  • Make a small opening below your collarbone to implant the neurostimulator.
  • Make another small opening behind your ear and pass an extension wire under your skin of the head, neck and shoulder.
  • Use the extension wire to connect the lead to the neurostimulator.
  • Close the openings, hiding the neurostimulator device and the wires.

Stimulator programming

One to two weeks after surgery, you will see your neurologist for your first programming appointment. Programming is simple and painless; it does not involve additional surgeries.

  • Your neurologist will turn on the stimulator and adjust the settings to determine the best setting for your specific symptoms.
  • It can take several adjustment appointments to find a setting that improves your symptoms.
  • Once your doctor has found a setting that works for you, you will need minor adjustments two or three times a year or if your symptoms begin to change.
  • While rare, it is possible that DBS will not provide any improvement in your symptoms. If you do not experience any change — or if your symptoms get worse — talk to your neurologist about your options and the possibility of turning off your DBS.

Why choose Rush for deep brain stimulation

  • The movement disorders surgery program at Rush specializes in using deep brain stimulation (DBS) to treat symptoms related to Parkinson’s disease, essential tremor and dystonia.
  • The movement disorders team at Rush is one of the largest and most experienced such groups in the world, with clinicians who specialize in managing the symptoms of Parkinson’s and other movement disorders.
  • The neurology and neurosurgery program at Rush is consistently named among the best in the country in U.S. News and World Report.