What are the advantages of deep brain stimulation (DBS)?
Deep brain stimulation (DBS) has many advantages:
- DBS does not cause permanent damage in any part of the brain, unlike thalamotomy and pallidotomy, which surgically destroy tiny areas of the brain and therefore is permanent and not reversible.
- The electrical stimulation is adjustable and reversible as the person's disease changes or his or her response to medications change.
- Because DBS is reversible and causes no permanent brain damage, use of innovative not-yet-available treatment options may be possible. Thalamotomy and pallidotomy result in small, but permanent changes in brain tissue. A person's potential to benefit from future therapies may be reduced if undergoing these procedures.
- The stimulator can also be turned off at any time if DBS is causing excessive side effects without any long-term consequences.
What are the risks and complications of deep brain stimulation (DBS)?
As with any surgical procedure, there are risks and complications. Complications of DBS fall into three categories: surgery complications, hardware (device and wires) complications, and stimulation-related complications.
- Surgical complications include brain hemorrhage, brain infection, wrong location (misplacement) of the DBS leads, and less than the best location (suboptimal placement) of the leads.
- Hardware complications include movement of the leads, lead failure, failure of any part of the DBS system, pain over the pulse generator device, battery failure, infection around the device and the device breaking through the skin as the thickness of skin and fat layer change as one ages.
- Stimulation-related complications occur in all patients during the device programming stage. Common side effects are unintended movements (dyskinesia), freezing (feet feel like they are stuck to the floor), worsening of balance and gait, speech disturbance, involuntary muscle contractions, numbness and tingling (paresthesia), and double vision (diplopia). These side effects are reversible when the device is adjusted.