Deep Brain Stimulation (DBS) for Parkinson's Disease

DBS Procedure for Parkinson’s Disease

Beth Israel Deaconess Medical Center (BIDMC) specialists offer deep brain stimulation (DBS) to treat certain neurologic conditions, including Parkinson’s disease.

Deep brain stimulation uses a surgically implanted device called a neurostimulator, which is similar to a heart pacemaker. This device delivers electrical stimulation to targeted areas in the brain that control movement. After surgery, our team monitors and adjusts the stimulator as needed during clinic visits.

Candidates for DBS

Your doctor considers many factors to determine whether DBS could help you:

• Your symptoms
• Your past response to medications
• Your age
• Your ability to come to BIDMC for frequent follow-up visits

Most candidates typically have a good response to medications (particularly levodopa) but experience increasing complications from the medications. This can include an increased time for medication effects to wear off and/or involuntary movements from the medications themselves.

To be a candidate for DBS, you also should be able and willing to come to BIDMC for frequent pre-operative visits, as well as visits for three to six months after the surgery. After counseling and education, you should show a good understanding of how the therapy works and have realistic expectations about the benefits, side effects and possible complications.

If you have freezing of gait (when you get stuck as you try to walk) or soft voice, DBS may not help you.

Getting Started

If you and your doctor decide you might be a good candidate for this surgery, you’ll meet with a number of specialists on our team for a series of exams and tests. Through this process, we’ll be better able to tell if surgery could help you without posing any unusual risk.

The process will include these steps:

• An in-depth evaluation of your Parkinson’s condition. You’ll come to our clinic without taking your usual morning Parkinson’s medications. You’ll spend four to six hours with a nurse practitioner, neurologist and other members of our staff as you follow your usual medication schedule. During the visit, staff will carefully evaluate your symptoms and your response to the medication.
• Neuropsychological testing. You’ll meet with a neuropsychologist for tests to check how well your brain functions in these areas:
  • Attention and concentration
  • Executive functions
  • Learning and memory

  • Processing speed
  • Reasoning
• Meeting with the neurosurgeon. You also will meet with the neurosurgeon who will perform the operation. During this thorough exam, you can ask questions and discuss your concerns about the surgery. If needed, our team also will schedule you for a brain MRI.

Once all these exams are complete, our team will review the results. We will work together to decide whether or not surgery is right for you.

If our team feels that you should try further treatment with medication, we will provide these recommendations to you and your referring doctor. If we recommend DBS surgery, it should be scheduled for about one month out. Once we schedule your surgery, you’ll get details about coming to the hospital for routine pre-operative tests.