Deep Brain Stimulation (DBS)
The movement disorder neurologists and functional neurosurgeons at the Vickie and Jack Farber Institute for Neuroscience are Deep Brain Stimulation (DBS) experts and able to offer important improvements in the procedure. With more than 20 years’ experience in DBS – and as the only health system in the region to offer Robotic DBS – we are leaders in Robotic Functional Neurosurgery expertise. Our neurologists, neurosurgeons, nurse practitioners and a coordinator meet monthly to discuss patients’ progress, ensuring you receive the most coordinated, multidisciplinary care available.
Who Does Deep Brain Stimulation Help?
An estimated 208,000 DBS devices have been implanted for treatment of neurological and neuropsychiatric disorders worldwide, the vast majority of which were for Parkinson’s disease and essential tremor patients. DBS may also benefit patients who:
- are not responding to medications or experiencing unbearable side effects from them
- have epilepsy
- have obsessive-compulsive disorder
- have depression (currently in clinical trials)
While the specifics as to how DBS works is still unknown, the electrical stimulation of the brain reduces symptoms of Parkinson’s disease and tremors by improving mobility, reducing involuntary movements and increasing an overall quality of life.
Jefferson takes the FDA required steps to offer DBS to patients suffering from dystonia (a disease causing repetitive, involuntary muscle contractions) and severe cases of obsessive-compulsive disorder that do not respond to therapy or medications.
What Does Deep Brain Stimulation Involve?
DBS involves using a pacemaker-like device to deliver stimulation to areas within the brain. Far from an experimental procedure, an estimated 208,000 DBS devices have been implanted for neurological and neuropsychiatric disorders worldwide. Jefferson experts are skilled at performing the procedure with patients asleep, unlike at other centers, where DBS is done with patients awake.
There are many advantages to asleep DBS, including the reduction of anxiety before surgery. Asleep DBS also helps to streamline the patient experience. Traditional DBS is usually done in two stages, while asleep DBS is performed in one procedure, without the need for a second surgery.
Jefferson is the only hospital in eastern Pennsylvania and southern New Jersey to routinely offer patients a choice between conventional DBS and asleep DBS and has performed the largest number of cases in the region.
What to Expect
Prior to either type of DBS, you will undergo an MRI on our advanced 3 Tesla MRI scanner – a magnet twice as strong as most scanners — in order to provide the most precise images to your surgeon.
On the day of the procedure, you will be fitted with a metal frame to help accurately place the electrodes, and then you will be put to sleep by an anesthesiologist. The metal frame will be attached to the table to improve your neurosurgeon’s accuracy, who will then drill very small holes in your skull.
In regular DBS, the anesthesiologist will then wake you up for the next part of the procedure in which the neurosurgeon will advance thin wires, called leads, into your brain using your MRI scan and real-time x-ray imaging as guidance. This will not cause any pain since the nerves of the brain cannot feel sensation.
Your neurosurgeon will ask you to raise your hand at various points throughout. They will then send small electrical currents through the leads and evaluate your tremors. When the leads are in the correct place, you will be put back to sleep and the procedure will be completed.
For patients having asleep DBS the procedure is different. It relies on the advanced imaging provided by our MRI scanner and an intra-operative CAT scan. You will be put to sleep by an anesthesiologist, and the leads will be placed using intra-operative imaging. You will wake up in the recovery room. We are proud to be the only hospital in the region routinely offering this technique.
Both DBS procedures involve a one or two-day hospital stay. Most patients will return one to two weeks after the procedure to have an electrical generator placed near your shoulder. This procedure is always done with you fully asleep and takes only about thirty minutes. You will return home the same day the generator is placed.
Your movement disorder neurologist will adjust the electrical stimulation level to ensure you have the best possible results after your surgery. This is done over a series of outpatient visits using a special programming device.
During these follow up visits, your neurologist will also adjust your medications. While most people with DBS still need some medications, they may decrease in dosage. Jefferson’s movement disorder specialists have the experience needed to give you the best possible quality of life by reducing your doses as low as possible.
Make an Appointment
Call 1-800-JEFF-NOW (1-800-533-3669) to make an appointment with a Deep Brain Stimulation specialist.