Deep Brain Stimulation (DBS)

DBS is not right for everyone, as many symptoms, such as those impacting speech, swallowing, thinking, or gait (balance and freezing), do not consistently respond well to DBS.

• Pros: While there may be some scarring, DBS is not felt to damage healthy brain tissue or destroy nerve cells. Instead, the procedure interrupts problematic electrical signals from targeted areas in the brain.
• Cons: Like any surgery, the procedure does carry risks including side-effects, infection, stroke, bleeding, or seizure.

The most common side-effect of DBS is dysarthria which may result in reduced clarity of speech, slurred or slow speech, making it hard to understand (2). There can also be slight changes in finding the right words to say or personality changes. A small number of people living with Parkinson’s have experienced cognitive decline after DBS surgery. 

DBS can be life-changing for many people with Parkinson’s, but it’s important to have realistic expectations and discuss all potential risks and benefits with your healthcare team.

DBS is typically recommended for people with advanced Parkinson’s disease who experience:

• Motor fluctuations and difficulty in maintaining consistent symptom control with medication.
• Medication-induced dyskinesias, or involuntary movements caused by long-term use of Parkinson’s medications.
• Severe tremors that are not adequately controlled by medication.

How do I access DBS?

Your neurologist will usually bring DBS up if they think it might help you. However, there is a stringent testing process to determine if you would be suitable for the operation. It’s advisable to explore all available options and optimise your medications to alleviate your most bothersome symptoms before opting for surgery.

How to get DBS

1. Consultation: Start by discussing DBS with your neurologist. They will evaluate your symptoms, medical history, and overall health to determine if you’re a suitable candidate.
2. Referral: If your neurologist thinks DBS is a good option, they will refer you to a specialised DBS centre.
3. Evaluation: At the DBS centre, you’ll undergo a series of tests, including brain imaging (MRI or CT scans) and possibly recordings of brain cell activity.
4. Surgery: The DBS surgery involves two main steps:
5. Electrode Placement: Electrodes are implanted in the brain using MRI or CT guidance.
6. Implanting the Pulse Generator: A few weeks later, a device similar to a heart pacemaker is implanted under the skin in the chest or abdomen.
7. Programming: After the surgery, a neurologist will program the device to deliver the right amount of electrical stimulation.

Testing if DBS Would Work for You
Before the surgery, your neurologist will conduct a trial stimulation to see how your symptoms respond to the electrical impulses. This involves temporarily placing the electrodes and testing different stimulation settings.

The Process

• Pre-Operative Evaluation: Includes medical history review, physical examination, and brain imaging.
• Surgery: Electrodes are implanted in the brain, followed by implanting the pulse generator.
• Post-Operative Care: Includes regular follow-up appointments to adjust the device settings and monitor your progress.
• Lifestyle Adjustments: You’ll learn how to use a handheld controller to manage the device and check battery life.