Offering Asleep, Single-Stage Deep Brain Stimulation (DBS)

At Columbia Neurosurgery, our team continues to evolve its innovative Deep Brain Stimulation (DBS) Program through the work of our Functional Division’s Dr. Gordon Baltuch and Dr. Brett Youngerman. Deep brain stimulation (DBS) is a surgical procedure in which electrodes are implanted in certain areas of your brain. These electrodes deliver electrical impulses that affect abnormal activity in the brain. The stimulation is produced by a pacemaker-like device implanted under the skin in your upper chest. The device is connected to the electrodes in your brain by a wire traveling under the skin.

Learn more about DBS (link)

Columbia Neurosurgery is now one of the few places in the world where patients can benefit from Asleep DBS, meaning patients are sedated throughout the procedure. According to recent studies (link), “Compared with traditional awake DBS surgery, the improvement of motor symptoms and quality of life, reduced postoperative LEDD, stereotactic coordinates, and stimulation parameters were equivalent. Yet, the asleep group showed better mood and sleep improvement at 1-year follow-up.”

Additionally, a study in The Journal of Neurosurgery concluded, “Globus pallidus internus leads placed with the patient under general anesthesia by using direct anatomical targeting resulted in significantly improved outcomes as measured by the improvement in the off-medication motor score at six months after surgery.”

In addition to improved recovery and outcomes, the team can complete many of these procedures in one visit.

Dr. Brett Youngerman states, “We understand that undergoing Deep Brain Simulation surgery can be intimidating for patients and their families. We are constantly looking for innovative ways to improve the experience for our patients while achieving the optimal clinical outcome.”

Dr. Youngerman outlines three key advances in patient-centered DBS at Columbia Neurosurgery:

First, traditional DBS surgery was done with the patient awake for a portion of the procedure so that we can test for efficacy and side effects. The quality of our brain imaging and accuracy of our surgical techniques make it no longer always necessary to perform awake stimulation testing in the operating room and we can keep patients comfortably asleep under anesthesia for the entire procedure.”

Second, the DBS system was traditionally implanted in multiple surgeries staged weeks apart, for example, to treat both sides or to connect the battery. We have moved towards implanting the entire DBS system in a single surgery to minimize the number of times a patient has to return to the hospital and operating room. This is possible through improved efficiencies, such as imaging in the operating room and close collaboration with our experienced neuroanesthesiologists. 

Finally, we work with all three manufacturers of DBS systems so that we can offer patients the right features for them, such as rechargeable batteries, remote telehealth programming, and brain sensing technology. Our goal is to make it as safe and seamless as possible for patients to benefit from this life-changing technology.”

Learn more about Columbia Neurosurgery’s DBS program here.