Deep brain stimulation (DBS) is a surgical therapy used for the treatment of Parkinson’s disease (PD). DBS involves the surgical placement of a thin wire, with four electrical contacts at its tip, into a very specific and carefully selected brain region. This wire is called the DBS lead (pronounced “leed”). The DBS lead is connected to a pacemaker-like device that is implanted in the chest region below the collarbone. This device, called the neurostimulator or implantable pulse generator (IPG), contains the battery and computer source that generates the electrical pulses that will be delivered via the lead to the brain.
The brain is a complex organ with billions of cells and cell connections called synapses. These cells are connected to each other by axons, or “pipes,” that send messages back and forth. Communication is facilitated through a series of circuits that are organized to sort and process information. The connections in the brain circuits are similar to the electrical wiring in your house or car. If one circuit malfunctions, it can disrupt the entire system. Research has shown that in PD there are faulty signals in several brain circuits.
These faulty or disruptive signals seem to underpin many of the symptoms of PD (e.g., slowed movement, tremor, and stiffness). When electricity is introduced into the circuit it “disrupts the disruption,” restoring order and improving disabling symptoms. This symphony of changes elicited by electrical stimulation in some unknown way acts to combat the symptoms of PD.
The duration of DBS benefits varies from patient to patient, but in the majority of cases it lasts many years. Patients have now been followed for 10 or more years with DBS, and the general rule has been that if the symptoms still respond to dopaminergic medications, then DBS will continue to work. DBS also will continue to work long-term against tremor and dyskinesia.
Consultant your Neurologist who will determine if DBS is the right choice for you. Keep in mind that an expert neurologist may be able to improve PD symptoms so that DBS is not necessary, or could be delayed for several years.
The best candidates for DBS therapy will meet most of the following criteria: