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What is deep brain stimulation (DBS)?
Deep brain stimulation, or DBS, involves implanting a medical device called a neurostimulator under the surface of the skin in the abdomen or chest. Additionally, a soft, flexible wire called a lead is implanted in the brain.
The neurostimulator delivers constant low-voltage electrical impulses to targeted areas of the brain. During deep brain stimulation, these electrical impulses block or change the abnormally functioning nerve cells (neurons) in the brain that cause uncontrolled movement, bringing relief to the child or adult. In conditions like dystonia, a complex movement disorder that causes uncontrollable, repetitive, stiff, twisting or exaggerated motions, deep brain stimulation can reduce the number and severity of these motions.
Who benefits from deep brain stimulation?
Deep brain stimulation was originally developed for adults who have Parkinson’s disease. In 2012, the Food and Drug Administration (FDA) approved deep brain stimulation therapy to treat children, teens and adults with dystonia that hasn’t improved with medicine. Gillette was one of the first two hospitals in the U.S. to use deep brain stimulation therapy to treat children who have dystonia.
See how deep brain stimulation therapy helped Cooper, who has dystonia.
What are the benefits and risks of deep brain stimulation for dystonia?
Deep brain stimulation can help control symptoms of dystonia, but there is no cure. When the neurostimulator is turned on, it delivers stimulation that might decrease symptoms. It can take up to a year for a child or adult using deep brain stimulation therapy to see its full effect.
Deep brain stimulation is:
- Adjustable: The stimulation settings can be changed as needed.
- Reversible: Deep brain stimulation does not destroy or remove any part of the brain, and the neurostimulator can be removed.
Studies show that deep brain stimulation can be effective for primary and secondary dystonia. The greatest benefit occurs for children and adults who have primary dystonia and receive stimulation to the part of the brain called the globus pallidus internus (GPi). Results are especially positive for patients who:
- Have a lesser degree of disability
- Have surgery at an early age
As with any brain surgery, there are risks with deep brain stimulation. Side effects are possible, but they’re not usually permanent. An adjustment to the deep brain stimulator settings can often reduce or get rid of the side effects. Your medical team will discuss risks and side effects with you.
How can I prepare for deep brain stimulation surgery?
To prepare for a DBS placement procedure, please review the tips to prepare for surgery at Gillette. You can also explore the amenities available at Gillette before your stay.
What can I expect on the day of a deep brain stimulation surgery?
To implant the DBS system, most children will have a two-part surgery. During the first part, a neurosurgeon implants the thin wires (leads) on both sides of the brain. The post-surgery hospital stay for the deep brain stimulation procedure is usually two days.
Two weeks later, the neurosurgeon performs part two, implanting the deep brain stimulation device in the abdomen or chest. The post-surgery hospital stay for this procedure is one or two days.
After part two, the neurosurgeon activates the neurostimulator and sets it to send stimulation 24 hours a day.
Every child heals differently following deep brain stimulation, and outcomes depend on the neurologic condition of your child before surgery. Kids usually return to normal activities within a few weeks.
Once the device used for deep brain stimulation has been turned on, your child returns for up to four visits, every four to six weeks, to continue programming the neurostimulator.
Deep Brain Stimulation Services at Gillette Children's
If your child or family member has dystonia, they may find relief from deep brain stimulation. Gillette Children’s is one of a few hospitals in the nation to offer a pediatric deep brain stimulation program to treat conditions like dystonia.
Your child will work with a wide range of specialists to support deep brain stimulation treatment. Along the way, they may receive care from internationally recognized experts in areas including:
- Neurosurgery
- Gait and motion analysis
- Neurology
- Pediatric Rehabilitation Medicine
- Neuropsychology
- Child life
- Psychiatry
- Psychology
- Rehabilitation therapies
- Radiology and imaging
- Sleep medicine
- Social work
Whether your child uses deep brain stimulation or other treatments for complex movement disorders (such as dystonia and essential tremor), we provide lifelong support and education in a family-centered environment. Our multidisciplinary team will work closely with you to develop a customized treatment plan to fit the specific needs of your child.
