What is Deep Brain Stimulation (DBS)?

Deep Brain Stimulation (DBS) is a surgical treatment for certain movement disorders, such as Parkinson's disease, tremors, and dystonia, when symptoms are not adequately controlled by medication [4]. The procedure involves implanting very thin wires with electrodes at their tips into the brain. These electrodes send continuous electrical impulses to alter specific electrical signals in the brain and reduce the symptoms of these movement disorders [4].

How does the DBS device work?

A DBS device works by sending continuous electrical impulses to specific areas of the brain. The wires implanted in the brain are connected to extensions that are passed under the skin behind the ear and down the neck. These extensions connect to a pulse generator (a device similar to a pacemaker) that is implanted under the skin in the chest or abdomen area [4]. These electrical impulses help modulate the abnormal electrical signals that cause movement disorder symptoms, such as tremors or involuntary muscle spasms [4].

Conditions that may benefit from DBS

DBS is used as a treatment option for some people with movement disorders that do not respond adequately to medication. These disorders include:

• Parkinson's disease: It can help relieve tremors, slowness of movement, and difficulty walking [1].
• Essential tremor: It aims to reduce involuntary shaking movements.
• Dystonia: It helps alleviate involuntary and painful muscle contractions that cause twisting and repetitive movements [3].

It is important to note that DBS is not a cure for these conditions, but rather aims to improve symptoms and relieve pain [1]. For more information on these disorders, you can visit the page Movement Disorders: Tremors, Spasms, and Walking Difficulties (Arabic).

Important considerations before treatment

The decision to undergo DBS is an individual one made after a comprehensive assessment by a specialized medical team. The patient must discuss all potential benefits and risks with doctors. Risks associated with any surgical procedure include infection or bleeding. After surgery, the device requires precise programming and continuous follow-up to adjust stimulation settings to ensure the best possible results for the patient [4].

Does stimulation replace Parkinson's medications?

In Parkinson's disease, DBS is discussed for specific individuals when controlling symptoms with medication becomes more difficult. It does not cure the disease, and the patient may still need medication even if their symptoms improve after surgery. Therefore, the team explains the difference between symptom relief and stopping the disease, and determines whether the expected benefit justifies the risks of the operation for the individual's specific case. It is helpful to discuss the symptoms to be improved with the team and to continue the follow-up plan rather than changing medication based solely on the presence of the device [5].

Medical references

• What is Deep Brain stimulation? | Right Decisions
• Movement Disorders
• Glossary of Neurological Terms
• Parkinson's disease - Treatment - NHS