Deep-Brain Stimulation Cover story Deep-Brain-Stimulation Surgery Eases Symptoms for Patients with Some Movement Disorders STORY HIGHLIGHTS Deep-brain stimulation (DBS) functions like a pacemaker to correct abnormal patterns of brain activity for patients with neurological disease. DBS carries relatively minimal risk and in most cases significantly improves the patient’s quality of life. (continued from cover) electrodes are strategically placed in the brain. The pacemaker includes a chest-implanted generator that sends continuous pulses. Just as the heart pacemaker helps to correct an abnormal heart rhythm, the brain pacemaker uses these pulses to correct the abnormal patterns of activity in the brain for patients with neurological disease — easing the involuntary movements characteristic of such conditions as Parkinson’s disease and essential tremor. DBS is most commonly performed as an asleep/ awake/asleep procedure: The patient is asleep and anesthetized at the beginning of the surgery, as a hole is being drilled in the skull; once the potentially uncomfortable phase is over and the brain is exposed, the patient is awakened and asked to respond to verbal commands, providing feedback to assist the surgical team in optimal placement of the electrodes before being put to UCLAHEALTH.ORG 1-800-UCLA-888 (1-800-825-2888) sleep again as the skull is closed up. Since there are no pain receptors within the brain, patients experience no discomfort while awake during the operation. “This is a surgery whose goal is to improve function and quality of life,” explains Dr. Pouratian. “The best way to ensure that we are achieving that goal is to actually test the patient during surgery, when we first put the electrode in, and make sure we’re getting the benefits from the stimulation while limiting the side effects. If it’s not in the optimal position, that’s our opportunity to move the electrode.” First approved by the U.S. Food and Drug Administration (FDA) in the late 1990s, DBS carries relatively minimal risk and, in most cases, it significantly improves patients’ quality of life. “This doesn’t change the underlying disease,” Dr. Pouratian says. “It doesn’t change