If you or someone close to you is living with Parkinson's disease, essential tremor or dystonia, deep brain stimulation may be worth understanding properly rather than in outline.
DBS is a surgical procedure in which thin electrodes are placed in specific areas of the brain responsible for movement control. These are connected to a small pulse generator implanted under the skin, which sends electrical impulses that regulate abnormal brain signals.
Who it helps most
DBS is most effective for patients with:
- Moderate to severe tremor
- A response to medication that fluctuates through the day
- Symptoms that have become resistant to drug therapy
It is not a cure. It does not stop the disease progressing. What it does, reliably and in appropriately selected patients, is lengthen the periods when medication is working, reduce tremor and rigidity during those periods, and allow the daily medication dose to come down.
How candidacy is decided
The single most useful predictor is the levodopa response. Symptoms that improve when medication is working are the symptoms likely to improve with stimulation. Symptoms that never respond to medication — with the important exception of tremor — usually do not respond to stimulation either.
This is why assessment involves more than reading a diagnosis. At HealBridge we ask for neurologist reports, recent brain MRIs, a complete medication list, and video of the motor symptoms recorded both "on" and "off" medication. From that, our neurologists and neurosurgeons can say whether the pattern fits before anyone books a flight.
What to expect afterwards
Programming, not surgery, is where most of the benefit is achieved. The stimulator is generally not switched on immediately, and settings are refined over several sessions while medication is reduced in parallel. That is why we ask DBS patients to plan three to four weeks in Istanbul rather than a surgical week alone.
Read the full detail on the Deep Brain Stimulation page, including risks, the two stages of surgery, and how DBS compares with MRgFUS.