What is deep brain stimulation?
Deep brain stimulation (DBS) is a surgical treatment procedure in which a brain pacemaker is implanted to deliver electrical impulses to specific parts of the brain. This procedure is used to treat tremors, Parkinson's disease, and dystonia. Brain pacemakers were approved by the Food and Drug Administration (FDA) in 1997 as a treatment for essential tremor, in 2002 as treatment for Parkinson’s and in 2003 as a treatment for primary dystonia. In March 2005 the results of a Canadian study performed by doctors from the University of Toronto were published indicating that DBS may also alleviate symptoms in patients suffering from treatment-resistant clinical depression.
How is it done?
The brain pacemaker is implanted by a functional stereotactic neurosurgeon. This means that a stereotactic head frame is used to keep the patient’s head still during surgery and the neurosurgeon uses special imaging techniques, such as magnetic resonance imaging (MRI) or computed tomography (CT), to map the brain and locate the position of the site to be stimulated.
There are two parts to the surgery: the procedure to implant the leads and the surgery to implant the neurostimulator(s) and extensions. The patient is usually awake for the first part, during the placement of the leads, so that dialogue with the surgeon can establish precisely which part of the brain is being passed. For the second part, when the surgeon runs the extensions and positions the neurostimulator (generally in the chest wall), the patient is fully anesthetized. The length of surgery will depend upon whether one or two leads are to be placed in the brain. Some surgeries last up to five hours or more.
Why is it done?
Deep brain stimulation can provide continuous brain stimulation, which controls abnormal movements (shaking, twisting, stiffness and slowness) more effectively than treatments with medication. As a matter of fact, medication can be reduced or stopped completely after DBS therapy.
Risks & Complications
Potential side effects of deep brain stimulation
- Pins and needles; tingling sensations
- Feeling an electric shock
- Muscle cramps or contractions
- Abnormal movement
Potential surgical complications and risks
- Paralysis, coma, death
- Intracranial hemorrhage
- Leakage of cerebral fluid surrounding the brain
- Seizures
- Infection
- Allergic reaction to the implanted materials
- Temporary or permanent neurological complications
- Confusion or attention problems
- Pain at the surgery site
- Headaches
Alternative Treatments
- Exercise - although not necessarily an "alternative therapy," exercises like Tai Chi and yoga can lower your stress and help you to be more relaxed, and increase your energy, balance, and flexibility. In general exercise is a safe, effective and easy way to improve your well-being. Always check with your doctor before beginning an exercise program.
- Diet - by following your doctor's and dietitian’s guidelines and eating foods from all food groups and in appropriate portions, you can improve your health.
- Positive attitude - having a positive outlook cannot cure Parkinson's disease, but it can lower your stress and help you feel better.
- Treatment with medications.
Candidate Eligibility
- Advanced Parkinson’s Disease with inadequate control by medications or with intolerable adverse effects from medications.
- Essential Tremor with inadequate control by medications or with intolerable adverse effects from medications.
- Dystonia with inadequate control by medications or with intolerable adverse effects from medications.
Location
Neuroscience Center
Bumrungrad International Clinic (BIC) Building, 19
th floor
Bumrungrad International Hospital, Bangkok, Thailand
For Appointments and Inquiries
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