Brain

Deep Brain Stimulation (DBS)

More than 150,000 patients have undergone DBS. The present day techniques make it a very safe procedure.

Programming of DBS (Deep Brain Stimulation)

DBS programming is optimized to get best clinical outcome after the lead is effectively placed. Selection of best contact configuration, adjusting current amplitude, pulse width & frequency are the parameters adjusted rather than changing a single algorithm for DBS programming or reprogramming in movement disorders such as PD.

DBS programming starts by checking of impedance in all contact points that ensures intact hardware system. Lead fractures or other damage to the system usually manifest as abnormally high impedance in one or more contact points.

Intact contact points are then tested sequentially to establish the efficacy and side effect to current thresholds and its ranges. The lowest current threshold is delivered by additional programming once the optimal balance of efficacy and side effects are determined.

Reprogramming of DBS

Sometimes patients didn’t get good or desired relief from symptoms after undergoing DBS surgeries.

There might be different reasons for this e.g.

  • Inaccurate lead placement deep inside the brain missing the targets
  • Sub optimal post-operative programming of the DBS
  • Difficult to treat non-motor symptoms like dysarthria, sweating &sleep disturbance etc.
  • Unrealistic expectations from DBS surgery
  • Improper combination of DBS programming with drugs
Reprogramminig
Parkinson-patient-dr-paresh-doshi

We get many patients who have been operated at other centers but did not get the desired benefits out of DBS.

We help them using our skills, knowledge & experience to provide them optimum benefit from DBS surgery with relief from their major symptoms.

Mr. Karunakaran after DBS (Deep Brain Stimulation) Reprogramming

The working pattern of DBS system is very much complex. Some symptoms exclusively respond to programming, but there are some other symptoms that responds to drug adjustments e.g.

  • Dyskinesia: This usually responds to reduction in drugs, but reprogramming is necessary if this reduction in drugs brings out tremors in patients.

“Lack of energy”, “feeling of weakness” usually responds to drug management

  •  Freezing: This usually responds to programming
  • Uncontrolled tremors: This responds very well to DBS programming.

At our centre, we have a cumulative experience of 20 years in this field with more than 500 cases of DBS to help us understanding these problems and resolve them.

Dr. Doshi has been personally involved in programming of all the PD patients which has not yet failed.

Our reprogramming protocol

For reprogramming, we ask the patient to get admitted for 4-5 days. We perform a CT scan of brain to check the position of the electrodes and if available, review the previous records of the patient if he/she was not operated by us.

We check for the impedance to rule out lead or extension wire breakage. We reprogram the patient’s stimulation parameters using our algorithm. We have reprogrammed lots of patients from different centers across India and abroad.

You can view their testimonials on: www.neurologicalsurgery.in/testimonial

To schedule a reprogramming appointment, write to: pdoshi@neurologicalsurgery.in