DBS at The University of Tennessee Medical Center
Our Deep Brain Stimulation (DBS) interdisciplinary team is composed of movement-disorder neurologists trained in DBS, a neurosurgeon who specializes in DBS surgeries, physical therapists, neuropsychologists and a DBS coordinator.
We work together to evaluate each patient and strive for the best results possible for our patients. Every patient is discussed in a group conference because the best surgical and programming outcome is important to us. The choice of device, battery, lead target, and anesthesia are customized to patient symptoms, exam, preference, and medical history.
Our team is passionate about DBS and looks forward to guiding each patient through this journey. We will bring the latest technology and research to achieve the shared goal of giving patients the best quality of life.
The DBS referral process involves evaluation with one of our Movement Disorders specialists at The Cole Center for Parkinson’s and Movement Disorders to determine candidacy for DBS prior to initiating the preoperative process for DBS. In addition to the online referral form, further contact information for The Cole Center can be found through the link to The Cole Center site.
What is Deep Brain Stimulation (DBS) Surgery?
DBS is a brain surgery that uses electricity to help control problems with movement. Leads or electrodes are placed in certain areas in the brain depending on the movement disorder being treated. DBS treatment uses a medical device like a cardiac pacemaker. There are wires that connect from the pacemaker to the electrodes in the brain. Electricity is brought from the pacemaker-like device to the brain electrodes to control the movement disorder. However, it is not a cure and is not right for everyone. It primarily helps movement problems and does not treat all parts of patients’ diseases.
What Is DBS Used For?
DBS is a treatment option for some movement disorders. These include Parkinson’s disease, essential tremor and dystonia.
What Can DBS Surgery Improve?
DBS for Parkinson’s disease helps the symptoms that medicine helps. These typically include tremor, stiffness and slowness of movement. When DBS surgery is a success, DBS gives patients more time where they feel in the ON medicine state. DBS decreases times when medicine no longer seems to be helping symptoms. This is known as the OFF medicine state. DBS also often reduces or removes the excessive, involuntary movements which are known as dyskinesia.
For essential tremor, DBS can improve tremor so that you can complete your activities of daily living such as eating with utensils, drinking from a cup and holding a tray, to name a few.
DBS can improve muscular contractions contributing to abnormal postures in dystonia.
What Is the Patient Selection for DBS?
- Confirmed diagnosis of Parkinson’s disease for four years or more
- Responsiveness to levodopa medicine
Having one or more of the below:
- Motor fluctuations in which you have wearing-off periods when symptoms return because medicine isn’t working well. These include tremor, stiffness and slowness of movement
- Prominent tremor
- Uncontrolled, involuntary movements known as dyskinesia
Ideal candidates with dystonia and tremor are those who have not responded well to medicine options or, in the case of dystonia, additional procedural options like Botox injections.
DBS Surgical Procedure
There are two surgeries involved: electrode (lead) placement surgery and battery placement. DBS lead placement takes two to three hours and will likely be done in one surgery, but sometimes it may need two separate surgeries.
You may be awake or under general anesthesia depending on the type of movement disorder. Having verbal and physical responses from you in the OR can help to ensure the outcome is a success. You will return seven to 10 days after electrode (lead) surgery for battery placement. This surgical procedure will be done as an outpatient surgery. It will likely take one hour.