During DBS Therapy, a small, pacemaker-like device sends electronic signals to an area in the brain that controls movement. These signals block some of the brain messages that cause annoying and disabling motor symptoms. The device is placed under the skin in the chest (not in the brain). Very thin wires connect the device to your brain to enable the signals to reach the source of your symptoms.
What to Expect During Therapy
After the system is placed in your body, your doctor will adjust the settings to optimize the therapy for you. Getting the initial settings right may take several programming sessions. Later, your settings can be adjusted if your symptoms change. Most people don’t feel the stimulation. Some people may feel a brief tingling when the stimulation is first turned on. A few weeks after the procedure, you can go back to your normal daily activities. Always following your doctor’s instructions, you can gradually try activities that had become difficult for you.
So that you can receive DBS Therapy, a device similar to a pacemaker is placed under the skin in your chest. Very thin wires connect the device to your brain to enable the signals to reach the source of your symptoms. Here’s what to expect during and after the procedure that makes therapy possible.
Having the Procedure
The duration and steps of the implant procedure can vary, and the procedure typically lasts several hours. The hospital stay is usually a few days for the preoperative tests, planning, implant procedure, and initial recovery before home care. Your surgical team will include:
- A neurologist
- A neurosurgeon specialized in DBS Therapy
- Other healthcare professionals
People who have had the procedure usually describe it as demanding and exhausting rather than painful. Afterwards, you may have some discomfort and soreness that can be managed with pain medication.
Implanting the Leads
In the first part of the procedure, your neurosurgeon places the leads in a precise part of your brain. Your brain is mapped with an MRI or CT scan. You will be awake so you can help your surgeon determine the best place for the lead. You will be lightly sedated and will not experience pain. Your surgeon may test stimulate areas of your brain while you move your arms or legs, tap your fingers, move your hands, or pretend to drink from a cup. This helps your surgeon find the best lead position to control symptoms like tremor, rigidity, or slowness of movement.
Implanting the Neurostimulator
The neurostimulator may be implanted the same day or later. You will be sedated and asleep for this part of the procedure. The surgeon begins by checking to see that the leads are properly positioned. The neurostimulator is placed under the skin of your chest just below the collar bone. The surgeon will also connect the lead to the neurostimulator with extensions that are placed under the skin, leading up from the chest to your neck and head.
People usually go home a few days after the surgery. Healing can take several weeks. Discomfort or pain at the incision sites can be managed with medication. When you are sent home to heal, typically your device will not be turned on until your first programming session. For several weeks you will avoid strenuous activity, arm movements over your shoulder, and excessive stretching of your neck. You may gradually want to try activities that were difficult before your surgery. Talk about this with your doctor first, and be sure to follow all of your doctor’s instructions.
After you have healed from the procedure, your doctor will program the device to best control your individual symptoms while minimizing side effects. You will return for follow-up sessions to further adjust the settings. Periodic adjustments are a routine part of DBS Therapy. After the initial programming, people with tremor may feel a brief tingling sensation, and usually experience relief from symptoms almost immediately. However, results vary. People with other symptoms of Parkinson’s disease often do not feel any sensation, and the full effect of the therapy may not be immediate. You will see the best results after the system has been fine-tuned for your specific symptom control needs. It may take several months to reach maximum effect. Depending on the system and your therapy needs, you may have a controller that will allow you to turn the system on and off, adjust the stimulation, and check the battery.
What Are the Risks of the DBS Therapy Implant Procedure?
DBS Therapy requires brain surgery. Risks of brain surgery may include serious complications such as coma, bleeding inside the brain, seizures and infection. Some of these may be fatal. Once implanted, the system may become infected, parts may wear through your skin, and the lead or lead/extension connector may move. Medtronic DBS Therapy could stop suddenly because of mechanical or electrical problems. Any of these situations may require additional surgery or cause your symptoms to return. Talk to your doctor about the risks that may be applicable to your specific situation.