Deep Brain Stimulation
Deep brain stimulation (DBS) could be the answer. Think of DBS like a pacemaker for your brain. Instead of sending electrical impulses to your heart, DBS sends impulses to your brain. These impulses help stop the signals that cause your symptoms.
Cleveland Clinic neurosurgeons have used DBS to treat more than 1,000 people with movement and neurologic conditions, like Parkinson’s disease, essential tremor, epilepsy and obsessive-compulsive disorder (OCD). We want to help you, too. Our number one goal is to get your symptoms under control so daily life is enjoyable, not challenging.
Why Choose Cleveland Clinic for Deep Brain Stimulation?
Skilled, collaborative providers:
Our neurosurgeons are fellowship-trained in stereotactic and functional neurosurgery. They work closely with Cleveland Clinic neurologists (specialists in the brain and spinal cord), neuropsychiatrists and neuropsychologists to make sure you have the most comprehensive and advanced treatment options. Meet our team.
Our specialists have used DBS to treat more than 1,000 people. We also offer second opinions and offer redo surgeries if DBS placements at another hospital have failed to improve your symptoms.
Cleveland Clinic is at the forefront of innovation and research for DBS. We use the newest technology, including the FDA-approved SenSight™ Directional Lead System (Medtronic), which helps us personalize therapy to fit your unique needs.
Our experts ask about your symptoms and how they affect your life. We use this information to design a personalized treatment plan that focuses on what’s best for you. We’ll explain how DBS works and how it might help, so you can decide whether or not you want to have the procedure.
Not all appointments need to be in person. Virtual visits let you meet with your provider from the comfort of home using your smartphone, tablet or computer. This safe and convenient alternative is especially helpful for follow-up visits and second opinions.
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What to Expect with Deep Brain Stimulation
With DBS, our neurosurgeons place leads (thin wires with electrodes on the end) into your brain. These electrodes send electrical impulses to the part of your brain that controls how you move or that’s linked to your neurologic condition. These impulses help stop the signals that cause your symptoms.
We also put a battery-powered device called an internal pulse generator (IPG) under the skin in your upper chest. The IPG sends signals to the leads. Specialists connect the IPG to the leads with extension wires that run through your neck and behind your ear.
During follow-up visits after DBS surgery, we’ll program the IPG to focus on your specific symptoms.
Conditions We Treat with Deep Brain Stimulation
With DBS, Cleveland Clinic experts can help control symptoms of:
If you have any of these conditions, our neurology experts may recommend DBS. But before we do, we’ll talk with you about how your symptoms are affecting your daily life and what your treatment goals are.
Second opinions for DBS
Considering deep brain stimulation but aren’t quite sure it’s for you? Or maybe you’ve had the procedure, but it doesn’t seem to be working. Getting a second opinion can help you make informed decisions about your health.
At Cleveland Clinic, our specialists are ready to meet with you, either in person or virtually. We’ll answer your questions, talk about your concerns and offer our expertise and recommendations in a kind and caring way.
Second opinions can give you peace of mind knowing that you’re in the most capable and compassionate hands.
Providers Who Perform Deep Brain Stimulation
LocationsOur healthcare providers see patients at convenient locations throughout Northeast Ohio and Florida.
Deep Brain Stimulation Treatment at Cleveland Clinic
There are several reasons we may recommend DBS:
- Your medications no longer control your symptoms or wear off quickly.
- You can’t tolerate higher doses of medications and the side effects of these medications.
- You have movement disorder symptoms on one or both sides of your body.
If you’ve decided to try DBS, our specialists will start by reviewing your medical history. Then, during a two-day evaluation, you may meet with a:
- Movement disorder specialist: A neurology expert with specialized training in movement disorders, like Parkinson’s disease.
- Neurologist: A doctor who diagnoses and treats problems with your brain, nervous system and spinal cord.
- Neuropsychiatrist: A medical doctor who treats conditions or traumatic brain injuries that affect how your brain works.
- Neuropsychologist: A psychology expert who treats cognitive (thinking and memory) problems due to injury or disease.
We’ll record video as you move and look at your movements to see if DBS can help your symptoms. We use imaging tests, including MRI or CT scan, to find the exact areas in your brain that cause your symptoms. During the surgery, we may insert a small wire to record — or map — nerve activity (microelectrode recording) in these parts of your brain.
Cleveland Clinic experts use this information to create your personalized DBS treatment plan. But this doesn’t all happen at once. We complete DBS in stages.
Before deep brain stimulation
You may spend the night in the hospital before your DBS procedure. If you have Parkinson’s disease, you’ll stop taking your medications. We also need to shave your head before DBS surgery.
During deep brain stimulation
Our neurosurgeons typically use frame-based DBS. We place your head in a special frame to help keep you still while we put the leads in your skull. Your neurosurgeon will:
- Sedate you before making a small opening in your skull to insert the leads.
- Use intraoperative navigation (imaging known as 3D fluoroscopy) to check the placement of the leads. We may then test the area using recordings or stimulation to see how you respond to the lead implant.
- Place an IPG for each lead in your upper chest, just under your skin.
- Connect the lead to the IPG with an extension wire.
You may be awake briefly when we place the leads, but you’ll be sedated at all other times. Most people don’t feel any pain during the surgery. Your neurosurgeon and neurologist will talk with you and test the device during DBS. We’ll have you make certain movements to be sure the leads are working.
After deep brain stimulation
After deep brain stimulation surgery, you may spend one night in the hospital. Most people can return to light activities a few days after the procedure.
During follow-up appointments, your neurologist makes any adjustments to the IPG’s programming, if needed. These adjustments make sure your brain is getting the right level of impulses in the target area to help with your symptoms.
Benefits and Risks of Deep Brain Stimulation
Deep brain stimulation doesn’t cure a disorder. But many people who receive deep brain stimulation have reduced symptoms.
If you have DBS for Parkinson’s disease, you still need to take your medications. But you might need less medication or notice that your medication’s benefits last longer.
Since, DBS isn’t permanent, our experts can stop this treatment if you want to. Some people treated with DBS may have:
- Balance problems or problems with speech.
- Seizures, but those are very rare after this type of surgery.
Your healthcare provider will talk to you about any complications that might happen with DBS. They’ll also explain the treatment’s potential benefits and limitations in controlling your symptoms.
Taking the Next Step
It’s natural to be a little nervous when trying a new procedure. You might worry about side effects or risks. Maybe you’re wondering if it’ll be worth it. Deep brain stimulation (DBS) does come with risks and potential side effects, but it also opens the door to new possibilities. Can DBS really make life better? We’ll answer your questions and help you through any challenges that come up. This treatment isn’t permanent, and it won’t solve everything, but it can help you enjoy tomorrow and look forward to more good days.
Getting an appointment with Cleveland Clinic deep brain stimulation experts is easy. We’re here to help you get the care you need.
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