Deep Brain Stimulation Program
Emory University in Atlanta, Georgia, is one of the oldest and largest centers in the U.S. providing deep brain stimulation (DBS) surgery for treatment of movement disorders such as Parkinson’s disease, tremor and dystonia. The program was established by Dr. Mahlon DeLong who along with his research team made groundbreaking discoveries in the function of motor circuits that led to the development of DBS.
DBS is a minimally-invasive surgical therapy that involves placing thin stimulation electrodes into deep regions of the brain that control motor function. A pacemaker implanted in the chest sends electrical impulses through the electrodes, which regularizes abnormal brain activity and alleviates motor symptoms. In Parkinson’s disease, DBS improves tremor, motor fluctuations and dyskinesias. In dystonia and tardive syndromes, it relieves involuntary muscle contractions and twisting movements. DBS can also be used to treat other conditions such as major depression, Tourette syndrome or chronic pain.
Emory DBS clinical team is composed of 7 neurologists, 1 nurse practitioner, 3 neurosurgeons, a neurophysiologist, 2 neuropsychologists, and a psychiatry nurse practitioner. We perform close to 100 implantations annually. In select cases, we also offer radiofrequency (RF) ablations and gamma knife surgeries. We perform both ‘awake’ and ‘asleep’ surgeries for lead implantations, and utilize devices from all 3 FDA-approved manufactures. Specific approach is customized to each patient to achieve the best clinical benefit and account for individual preferences.
All patients interested in DBS at Emory are first evaluated by one of our Movement Disorder specialists. Patients can call 404-778-3444 to schedule an appointment. Once diagnosis is confirmed and necessary medication trials completed, appropriate patients are referred to the DBS clinic. After meeting with a DBS neurologist, patients undergo DBS screening steps.
DBS screening includes:
- video exam (off and on medications for Parkinson’s disease)
- motion analysis (objective measure of motor symptoms using body sensors)
- neurocognitive evaluation (detailed testing of memory and thinking abilities)
- psychiatry evaluation
- brain MRI
Once screening is completed, the test results are discussed in a multidisciplinary conference. Patients who are deemed appropriate candidates are then referred for neurosurgery evaluation. After final neurosurgery clearance, patients are scheduled for surgery. The time from initial DBS evaluation to surgery is approximately 6 months. DBS surgery is typically performed in two stages which are two weeks apart: stage 1 for brain lead(s) implantation and stage 2 for battery placement. Approximately 4 weeks after brain lead implantation, patients are scheduled for initial programming when DBS device is first turned on. Patients undergo several programming visits to adjust stimulation parameters to achieve optimal benefit. DBS batteries are typically replaced every 3-5 years, but longer lasting rechargeable devices are also available.
Emory is academic affiliate for Atlanta Veterans Administration Medical Center (VAMC). Veterans seeking deep brain stimulation through the VAMC can be referred to Birmingham VA or Richmond VA PADRECC centers, or in certain cases treated at Emory.
For additional information on DBS, visit these sites: