If you or a loved one is struggling with persistent symptoms after a traumatic brain injury, you may have come across deep brain stimulation in your search for options. And while this can be an effective treatment, it is not for everyone.
This guide from Neurodiagnostics Medical P.C. discusses deep brain stimulation in more detail and what makes someone a good candidate. Connecting with the best neurologist in NYC for an evaluation can help you understand your options before committing to this or any treatment decision.
Understanding Deep Brain Stimulation and TBI
According to the Centers for Disease Control and Prevention, TBIs happen most often after falls, assaults, firearm-related injuries, and car accidents. Many survivors experience lasting cognitive, motor, or mood-related challenges that do not respond fully to medication or rehabilitation. DBS has emerged as an option for certain patients facing these types of long-term neurological challenges.
During deep brain stimulation after a brain injury, candidates undergo a neurosurgical procedure that uses implanted electrodes to deliver electrical signals to specific brain regions. A pulse generator implanted near the collarbone typically delivers this controlled stimulation. The U.S. Food and Drug Administration first approved deep brain stimulation for essential tremor in 1997 and for Parkinson’s disease in 2002, and research into TBI recovery applications is ongoing.
Candidates for Deep Brain Stimulation After a Brain Injury
Who qualifies for DBS treatment after traumatic brain injury? Candidates are generally adults whose symptoms persist despite trying conventional treatments for at least several months to a year. Your neurosurgeon will also look at how your symptoms affect daily life.
Research published by the Parkinson’s Foundation focuses on movement disorders but outlines principles that may apply to candidacy for deep brain stimulation after a brain injury. These principles include having a thorough consultation with a neurosurgeon, undergoing neuropsychological testing to determine symptom severity, and evaluating your response to prior treatments.
Typically, the eligibility criteria for deep brain stimulation surgery include:
- A confirmed diagnosis of a condition that may respond to DBS, such as a movement disorder or certain cognitive symptoms following TBI
- Symptoms that significantly disrupt daily work or quality of life
- Limited improvement from medications or physical therapy
- Stable mental health
- Generally good physical health to tolerate surgery and anesthesia
DBS may improve attention, executive function, and processing speed in some TBI patients, but since results vary, realistic expectations are vital.
How DBS Supports TBI Recovery
Brain injury rehabilitation using deep brain stimulation aims to regulate abnormal activity. The procedure delivers steady electrical pulses to regions involved in movement, mood, or cognition. For TBI patients, the central thalamus is often the target.
A phase-one feasibility study published in Nature Medicine reported that processing speed on the Trail Making Test improved between 15% and 52% in five patients with moderate-to-severe TBI who received central thalamic DBS. While these results beat the 10% benchmark for clinical improvement, it is important to acknowledge that DBS can only help manage specific symptoms, not cure brain injury.
What the Evaluation Process Involves for Deep Brain Stimulation After a Brain Injury
Candidates will undergo a thorough screening process that can take weeks or even months, involving a neurologist, a neurosurgeon, a neuropsychologist, and a psychiatrist. You will likely undergo brain imaging, such as an MRI, and a detailed review of your medical history. This multidisciplinary evaluation helps confirm whether the potential benefits for TBI recovery outweigh the surgical risks for you.
You may not be a candidate if you have severe dementia, an untreated psychiatric illness, or medical conditions that make surgery dangerous. People whose symptoms are mild or well controlled by medication are also less likely to be approved. Brain imaging that reveals extensive damage in target areas can further limit options.
If DBS is not right for you, your care team may suggest other therapies such as cognitive rehabilitation, medications, or non-invasive brain stimulation methods.
DBS Risks and What To Expect
According to the International Brain Injury Association, an estimated 5.3 million Americans live with a disability related to traumatic brain injury. The scale of unmet need for advanced treatments like DBS is vast, but like any brain surgery, it carries risks. Some of the primary concerns include the risk of infection, bleeding, seizures, and stroke, with potential side effects after surgery of mood changes, speech difficulties, or tingling sensations.
Recovery from the procedure usually takes a few weeks. You should plan for ongoing follow-up appointments throughout your life, as implanted batteries may need replacement every three to five years.
Frequently Asked Questions
If you are considering deep brain stimulation after a brain injury, you likely have questions about what to expect. Below are answers to some of the most common questions people ask when researching DBS as a treatment option after a TBI.
How Long Does Deep Brain Stimulation Surgery Take?
Deep brain stimulation surgery typically takes between four and six hours, though this depends on the protocol being used and the complexities of the case. The delicate procedure involves placing electrodes in the brain and implanting a pulse generator.
Is Deep Brain Stimulation Reversible?
Yes, deep brain stimulation is considered a reversible procedure. The medical team can turn off the device or remove the implants.
Can DBS Help With Memory Loss After a Brain Injury?
With deep brain stimulation after a brain injury, candidates with memory loss may experience improvements in certain cognitive symptoms, including aspects of memory and attention. However, DBS is not currently approved as a standard treatment for memory loss, and results vary by patient.
