Deep Brain Stimulation for Movement Disorders

For many patients struggling with a movement disorder, deep brain stimulation (DBS) can be a life-changing procedure. This innovative treatment option works by stimulating different parts of the brain with electricity to change its function.

Discover how DBS can be an effective treatment option for those dealing with symptoms of a movement disorder.

How DBS Works

During a DBS procedure, the neurosurgeon places a set of electrical contacts deep in the structures of the brain. These contacts are then connected to a cord that runs under the skin to the device’s battery. The battery is placed under the skin in the chest, holding the electronics to be able to control the brain stimulation.

The electricity then stimulates structures in the brain that connect to other nerve cells in the brain, providing symptom control.

“We don’t fully understand how it changes the behavior of the brain, but we know that it is effective in managing some neurological conditions,” shares Alastair Hoyt, MD, a neurosurgeon at the UToledo-ProMedica Neurosciences Center.

Conditions Treated with DBS

DBS is most commonly used to treat movement disorders. It is FDA-approved to treat the movement disorders of Parkinson’s disease, essential tremor and dystonia, as well as the other neurological conditions of epilepsy and obsessive-compulsive disorder (OCD).

“Depending on the condition being treated, different areas of the brain are targeted with the electrical stimulation,” shares Mehmood Rashid, MD, a neurologist at the ProMedica Neurosciences Center. 

DBS may be used in addition to medications, or may be used to manage conditions with few treatment options.

For people living with Parkinson’s, their medications typically become less effective over time and side effects from the medications increase. “DBS can essentially turn back time on their disease by making the medications more effective and reducing side effects,” Dr. Hoyt explains.

“Essential tremor affects over 5% of people over the age of 50. And many people are told that they just have to live with it. This simply isn’t true,” Dr. Hoyt shares. For many, DBS can decrease essential tremor symptoms by more than 70%.

DBS for dystonia can be less effective than DBS for the other movement disorders. However, it is one of the only treatment options for people with generalized dystonia at this time, so it is an option for those struggling with the disorder.

Other conditions, including Tourette’s syndrome, depression, addiction and stroke rehabilitation, are being investigated and researched to see if DBS may help treat them. 

Who is a good candidate for DBS?

“If you have essential tremor, Parkinson’s or dystonia and the disease is interfering with your day-to-day life, even with medications, you’re a candidate for DBS,” Dr. Hoyt explains.

Dr. Rashid explains that a good candidate for surgery would also need to be physically able to undergo surgery with general anesthesia. They also need to have the right mindset, a good support system at home, and not have any sort of cognitive impairment, as DBS has been shown to worsen these symptoms in people already experiencing them.

What are the risks of DBS?

As with any surgery, there are risks to a DBS surgery. However, complication rates are fairly low. Dr. Hoyt shares that beyond the risks that come with any surgery, there are a few additional risks. There is a low risk of bleeding in the brain or new neurological injury, minimal risk of injury to other parts of the body when inserting the device, and in very rare cases, seizures.

Post-Procedure Care

The procedure is just the start of a patient’s DBS journey. “DBS is not one and done. The procedure begins a relationship between the patient and their neurologist that will continue over time,” Dr. Hoyt explains.

The device is not turned on right away after the procedure where the electrical contacts and device are placed. About one month after the procedure, when the patient has recovered from the procedure, they will visit their neurologist.

At this visit, the neurologist will turn on the DBS and complete an initial programming of the system. This visit may take anywhere from two to four hours, as the patient and neurologist work to find the amount of stimulation that is most effective in managing their symptoms.

After the initial post-procedure visit, the patient will see their neurologist every two to four weeks to finetune the system and their medications as their body adjusts. When the patient and their neurologist feel that symptoms are effectively being managed, they will move to a four- to six-month follow-up schedule.

“Over time, the patient’s disease will change. We can change the patient’s device stimulation levels and their medication dosages to help address the symptoms the patient is having at that time,” Dr. Hoyt explains.

Advantages of DBS

After receiving DBS, many patients are able to take minimal to no medications. This can be a huge benefit to patients who are experiencing a huge burden of managing medications or whose medications are no longer working to manage their disease.

Dr. Hoyt shares that he encounters many patients who feel that putting something in their brain is experimental. However, it’s not. DBS is FDA-approved and has a well-proven record of success over the past 25 years.

“Don’t wait for your movement disorder to get so bad that you have no other options before you consider DBS,” Dr. Hoyt encourages. “Research is showing us that using DBS sooner can help significantly improve or maintain your quality of life earlier in the disease progression.”