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:

• Dystonia.
• Epilepsy.
• Essential tremor.
• Obsessive-compulsive disorder.
• Parkinson’s disease.

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.

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.
• Headache.
• Numbness.
• 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.