GETTING DBS DBS Therapy for Parkinson’s Disease

Your neurologist — typically a movement disorder specialist — will evaluate you to see if DBS is a good option for you. The evaluation usually includes:

• Medical history
• Neurological exam of your movements, both on and off medications
• MRI of the brain to check whether there are any issues that would pose a risk during the surgery
• Lab tests, such as a blood test to make sure your blood clots properly
• Neuropsychological tests

The doctor will share the results with you, and together you will decide whether to go forward with the therapy.

Before the Procedure

Your doctor will give you instructions about preparing for your surgery, including instructions for medications, eating, or drinking before surgery, and how long they anticipate you will be staying in the hospital. Your doctor may want to shave a portion of or your entire head for the procedure. Ask your doctor about everything to expect at your procedure.

Imaging and Mapping the Brain

You will have an MRI or CT scan to provide your surgeon with images and maps of your brain. Your doctor may attach a frame, or halo, to your head to help hold it steady during the scan. Your doctor will use these images to calculate 3-dimensional coordinates of brain locations for lead placement.

A neurosurgeon will implant the DBS system in two steps:

1. Placing the Lead(s): Implanting very thin wires (leads) that will carry electrical signals to precise areas of your brain.
2. Implanting the Neurostimulator: Placing a small pacemaker-like device (also sometimes called the "battery" or "device") under the skin of the chest. This creates the electrical pulses that help control movement symptoms of Parkinson's, including tremor, slowed movement, and stiffness.

Depending on your surgeon's preference these steps can either be done in one day or two separate days over the course of a few weeks.

Placing the Lead(s)

Your neurosurgeon will first place the lead(s) in the brain, guided by the images taken with MRI and CT scan to determine the precise location. For this part of the surgery, you may be either awake or asleep (under deep sedation or general anesthesia) depending on your neurosurgeon's recommendation. 

Differing from other DBS systems, Medtronic has FDA approval for both awake and asleep DBS to give your neurosurgeon more surgical flexibility.

If the procedure is performed while you are awake, you could feel some pressure and should feel no pain. You may be asked to move your arms or legs, tap your fingers, move your hands, or pretend to drink from a cup while your neurosurgeon stimulates areas of your brain to confirm the lead(s) are in the best location.

Implanting the Neurostimulator (Battery)

After checking that the lead(s) are properly positioned, your neurosurgeon will place the neurostimulator under the skin of your chest, just below the collarbone. Your neurosurgeon will connect the lead(s) to the neurostimulator using extensions that run under the skin from the chest to your neck and head. You will be under general anesthesia for this procedure. 

Healing and Care After Surgery

Most people spend a day or two at the hospital. Healing may take several weeks. You will have pain medications for any discomfort you may have at the incision sites.

While healing, avoid strenuous activities and heavy lifting. Don't raise your arms above your shoulders, and don't bend or stretch your neck excessively. As always follow your doctor's instructions.

Your neurologist will help you decide when you're ready to return to activities and will turn your device on at your first programming session a couple weeks after your surgery.

Risks of the Surgery

DBS Therapy requires brain surgery. Risks of brain surgery may include serious complications such as coma, bleeding inside the brain, stroke, seizures, and infection. Some of these may be fatal.

Once implanted, the system may become infected, parts may wear through your skin, and the lead or lead/extension connector may move. Medtronic DBS Therapy could stop suddenly because of mechanical or electrical problems. Any of these situations may require additional surgery or cause your symptoms to return or worsen.

Talk to your doctor about the risks that may be applicable to your specific situation. See Important Safety Information

Need help finding a neurologist or movement disorder specialist? Use our physician finder tool to find a specialist near you.

A few weeks later, your neurologist will turn on the neurostimulator and adjust the stimulation to best control your symptoms while minimizing side effects.

Then it's time to get back to your life!

• Return to your usual activities, always following your neurologist's guidance on what's okay and what to avoid.
• With the DBS system placed entirely within the body with no external components, there is minimal limitations on your daily activities, the clothes you can wear, or how you travel.
• DBS delivers therapy 24 hours a day, so it's working to control your symptoms when you wake up first thing in the morning.
• DBS doesn't require any maintenance from you (except for recharging if you have a rechargeable system).

It's extremely important to attend all of your checkups with the neurologist who manages your DBS therapy. Your neurologist will:

• Make sure that your DBS system is working properly.
• Adjust your stimulation to best control your symptoms.
• Check the battery of your neurostimulator to see if you will soon need a device replacement.

Living with DBS Therapy