Deep Brain Stimulation (DBS) for Movement Disorders and OCD
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What Is Deep Brain Stimulation?
Deep brain stimulation at UPMC has proven to be an effective treatment for involuntary movements associated with Parkinson’s disease and epilepsy, such as tremors, slowness of movement, rigidity, and problems with walking and balance. Deep brain stimulation is also approved for obsessive-compulsive disorder (OCD) treatment under a Humanitarian Device Exemption.
Deep brain stimulation is a surgical procedure in which a hair-thin wire (electrode) is implanted in the area of the brain that is responsible for abnormal movement. The wire is connected to a pulse generator that is implanted under the skin below the collarbone. Once activated, the generator sends mild electrical pulses through the wire to the brain. These electrical pulses modify the brain’s electrical signals to help control or stop abnormal movements.
Deep brain stimulation is both adjustable and reversible. New technology allows patients to use a remote control to adjust the level of stimulation needed to provide the greatest symptom relief with the least amount of side effects.
Patients who received deep brain stimulation have shown:
- Symptoms lessen by 40 to 60 percent
- Improved quality of life
- Increased independence
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How Is Deep Brain Stimulation Performed?
Depending on your condition and diagnosis, deep brain stimulation can be performed while the patient is either:
During the “awake” or traditional surgical method, you are scanned in an MRI suite prior to surgery. The surgical team uses these preoperative images to plan the procedure and as a roadmap to guide the implementation of an electrode into the brain. In certain cases, multiple electrodes are used.
While the electrode is being advanced through the brain, you do not feel any pain because of the unique nature of the human brain and its inability to generate pain signals. The surgical team is able to communicate with you and assess your brain functions to determine the best placement of the electrode.
Using the newly developed ClearPoint® Neuro Intervention System, UPMC neurosurgeons are able to perform deep brain stimulation inside a magnetic resonance imaging (MRI) scanner while you are asleep, allowing real-time images of the brain to guide the procedure while you are under general anesthesia.
The ClearPoint system includes:
- Specialized equipment designed specifically to work in a magnetic environment
- Advanced software that works directly with MRI images to provide step-by-step guidance for procedures. The software allows physicians to determine the optimum pathway and point of entry for a desired target in the brain before a single incision is made.
The system allows neurosurgeons to respond to shifting conditions and helps the entire procedure go smoothly and efficiently. Utilizing this technology also alleviates the fear of awake brain surgery and may open the doors to people previously not considered surgical candidates, such as children and people not physically able to undergo awake surgery.
UPMC is one of only a small number of institutions in the United States performing this advanced technique and offers expertise in both MRI-guided and traditional deep brain stimulation techniques.
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Who is a Candidate for Deep Brain Stimulation?
People with Parkinson's disease, essential tremor, dystonia, tremor due to multiple sclerosis, or with movement-related symptoms that cannot be controlled by medications are possible candidates for deep brain stimulation.
In addition, patients with chronic, severe, and treatment-resistant obsessive-compulsive disorder (OCD) may be eligible. Learn more about deep brain stimulation for OCD >>
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