Deep brain stimulation (DBS) is a technology that has been utilized for many decades to manage chronic pain syndrome. DBS is a nonsurgical treatment that delivers small electrical shocks to inactivate the parts of the brain that cause involuntary movements in patients with movement disorders.
At Temple, DBS is used to treat Parkinson’s disease, a degenerative disorder that impacts the neurons in the brain that produce dopamine. Tremor is a common symptom associated with Parkinson’s disease, and is one that may also be addressed through the use of DBS.
How Deep Brain Stimulation Works
Before doctors determine a patient is an appropriate candidate for DBS, patients may undergo a series of meetings with neurologists and neurosurgeons, as well as evaluations with physical and speech therapists. The patient will be cleared for surgery with a series of tests that includes blood work, a chest X-ray and an electrocardiogram. If the patient is cleared for DBS, surgery is scheduled.
Day of Surgery
On the day of the surgery, the patient’s head is fitted with a stereotactic frame topped by a localizing device. An MRI is performed, and the frame and the localizing device provide markers visible on the MRI for the area that will be targeted during the procedure. Using specialized software and the MRI results, the doctor can map the brain, identifying the exact location in the brain where nerve signals that cause involuntary muscle movements or tremors occur. Based on this information, the exact path coordinates necessary to place the electrode or electrodes are determined.
Once the patient is in the operating room, the stereotactic frame is secured and anesthesia is administered. Using the MRI results, the surgeon creates holes in specific locations in the skull, and a recording electrode is navigated through those holes and placed deeply into the brain at a precise angle and depth. Once doctors determine the electrode is in the right location on both sides of the brain, the permanent leads are placed and the device is tested and the incision is closed. Patients usually remain in the hospital overnight.
During the second part of the surgery, a pacemaker-like stimulator/battery pack is placed under the skin in the chest cavity or abdomen. The leads from the scalp are then attached to an extension wire that goes under the skin from the scalp and connects to the stimulator.
