Prior to DBS surgery, MRI or CT brain imaging is performed to create pictures of the brain that act as a map during the surgical procedure.
Other testing is also necessary. Blood count, kidney and liver function, heart health, and more are all measured. Additional testing determines the extent of a patient’s symptoms and whether mental health issues could reduce the procedure’s success.
DBS surgery begins with placing leads (wires) on the part of the brain that controls movement. This is done with the guidance of the CTs or MRIs taken earlier. During placement, the patient is awake but unable to feel pain. The surgeon may ask the patient to move a body part. This helps the surgeon ensure the leads are placed at the right place.
When the leads are in place, the neurostimulator is implanted. This device sends electrical signals to the leads. Essentially a small box, this pulse generator is placed under the skin right beneath the collarbone. The leads are then connected to the neurostimulator and the incisions are closed.
At UK HealthCare, certain Parkinson’s disease patients undergo DBS+. With this procedure, healthy nerves are transplanted to the area of the brain in which neurons are dying, potentially halting or reversing Parkinson’s-related nerve damage. The treatment is currently only offered at UK HealthCare Brain Restoration Center, where it is the focus of a clinical study.
Following the procedure, most patients will stay in the hospital overnight. As long as there are no complications, patients return home the next day. Pain medication may be prescribed when leaving the hospital.
Initially, the DBS will remain inactive until a few weeks after the procedure, when the patient returns to the hospital to have it programmed. This process is repeated as needed. As the patient’s condition progresses over time, the neurostimulator may need to be reprogrammed. This allows patients to maintain control over symptoms, even if their disease worsens.
In addition to programming needs, the batteries in the neurostimulator must be changed every few years. This outpatient visit, including face-to-face time with the physician, typically takes about an hour.