Deep Brain Stimulation: Cutting-edge Treatment for Movement Disorders
The Movement Disorders Center (MDC) at Wake Forest Baptist Health is one of the most experienced centers in the nation in the use of deep brain stimulation (DBS) to treat movement disorders. We were of the first to use DBS in patients with Parkinson’s disease and we continue to innovate in the use of this treatment in other FDA-approved movement disorders, including essential tremor, dystonia and obsessive-compulsive disorder.
How DBS Works
DBS uses electrodes placed in one or more areas of the brain to control the symptoms associated with movement disorders. Instead of permanently destroying the overactive cells responsible for the symptoms, DBS temporarily disables these cells by firing rapid pulses of electricity from one or more sites on the electrode. This treatment is programmable, which gives us a greater ability to control symptoms compared to traditional lesioning procedures.
Evaluating and Selecting Patients
Selecting patients who should receive DBS requires a thorough evaluation by a team of neurosurgeons, neurologists, psychiatrics, neuropsychologists and therapists. This evaluation includes a detailed health history and physical exam and, potentially, a videotaped evaluation of a patient on and off medicine.
Not all patients need DBS; we often advise patients whose conditions are well managed with current medication to defer surgery to a later time.
Surgery and Follow-up
Surgery is performed in 2 stages, several weeks apart. In the first stage, electrodes are placed in the brain. In the second stage, we place the generator, the electrodes’ power source, in the patient’s chest and connect it to the electrodes with an extension.
To ensure best results, we ask our patients to return for multiple visits just after implantation, during which the generator is reprogrammed and medications are adjusted to improve symptoms and decrease side effects. Follow-up appointments are scheduled less frequently once we have obtained optimal balance of medication and symptom control.
The generator typically lasts 2 to 5 years; replacement can be performed in a routine outpatient surgical procedure.
Our specialists, all of whom have extensive expertise in DBS, work closely with a multidisciplinary team to develop an extensive, individualized plan for each patient. The MDC coordinator helps referring providers and patients navigate our system, and provides them with the best possible medical experience.