Weighing Out the Benefits and Risks of Deep Brain Stimulation

Deep brain stimulation (DBS) is a surgical procedure where your provider implants a lead in the brain and a pulse generator just below your collarbone that’s designed to deliver a mild electrical current to a specific part of your brain. The current from the generator stimulates the brain cells where the lead resides, activating cells that aren’t working or correcting cells that are firing abnormally.

At Center for Neurosurgery Las Vegas, board-certified, multi-fellowship-trained neurosurgeon Dr. Scott Glickman uses deep brain stimulation to treat movement disorders such as Parkinson’s disease, dystonia, and essential tremor. The DBS device can also manage symptoms of obsessive-compulsive disorder (OCD) and epilepsy.

Since DBS involves surgery, it’s important to weigh the benefits and risks before going ahead with the procedure. Here’s what you need to know.

DBS and your brain

The human brain contains billions of neurons (nerve cells), and they communicate with each other using electrical and chemical signals. Certain brain conditions, such as Parkinson’s, decrease the activity between the cells themselves, as well as in the body part they control. That leads to problematic symptoms such as uncontrolled tremors, jerky movements, and speech alterations.

DBS uses an artificial electrical current to override the faulty system, making the neurons more active so they communicate more effectively. This helps improve symptoms throughout the body. Interestingly, though, researchers are still uncertain of the exact mechanism by which the system works.

Currently, the US Food and Drug Administration (FDA) has approved DBS to treat the following conditions:

• Dystonia
• Essential tremor
• Medication-resistant epilepsy
• Parkinson’s disease (when medication is no longer effective)
• Medication-resistant obsessive-compulsive disorder (OCD)

And researchers continue to investigate DBS as a possible treatment for other conditions, such as cluster headaches, dementia, substance use disorder, severe pain conditions, and multiple sclerosis (MS). However, it’s unclear at this point how effective the treatment may be.

Weighing the benefits and risks of DBS

DBS has a number of advantages. These include:

• Offers a treatment option when medications don't work or are no longer effective; controls symptoms with reduced side effects
• Can be a life-changing (or even life-saving) treatment, especially for conditions whose effects prevent you from doing routine activities and diminish quality of life
• Adjustable; doctor can fine-tune the pulse generator to what works best for you
• Reversible: surgeon can remove the leads and pulse generator if DBS isn’t effective or causes bad side effects

Some risks and complications come from the leads and/or pulse generator themselves:

• Incorrect placement or shifting of leads
• Lead wires come loose from pulse generator
• Failure of leads or pulse generator
• Pain or soreness around the pulse generator
• Pulse generator programming leads to side effects

Because DBS uses electrical current to stimulate targeted areas of your brain, the current may need fine-tuning before it has the most beneficial effects. That means you can experience symptoms while Dr. Glickman works on programming the pulse generator. These include:

• Balance difficulties
• Confusion or problems focusing
• Double vision
• Memory problems
• Numbness and tingling in body parts controlled by brain area(s) targeted
• Seizures
• Depression

Not every patient will experience all the same side effects and symptoms, but it’s important to discuss your case with Dr. Glickman before you decide to move forward with the treatment so you’re as well-informed and prepared as possible.

If you’re dealing with a movement disorder, epilepsy, or mental health condition that stems from impaired brain activity and function, deep brain stimulation may be an option to restore your quality of life.

To schedule a consultation with Dr. Glickman, call Center for Neurosurgery Las Vegas at 702-929-8242, text us at 725-210-0057, or book your appointment online.