Deep Brain Stimulation for Schizophrenia

If you have schizophrenia and medicine doesn't control your symptoms, deep brain stimulation (DBS) may be an option. It's a new treatment that uses electric pulses to help parts of your brain communicate better.

When you get DBS, a surgeon places wires and electrodes in your brain. They're connected to another device that he puts under the skin in your chest to control the electric signals.

What Happens During Surgery

You need two surgeries for DBS: one to place the electrodes and another to put in the device that controls them. The electrode placement is done first.

In the operating room, your doctor puts your head in a frame to keep it still. Then you'll get an MRI -- a machine that uses powerful magnets and radio waves to make a detailed picture of your brain. It gives your doctor a map to show them where to place the electrodes.

Your surgeon will drill a small hole in your skull and put in a thin wire with electrodes at the end into a specific area of the brain. You'll get medicine so you won't feel any pain while this is going on.

You're awake during the surgery so your doctor can talk to you and ask you to move your arm or leg. Your responses help make sure the electrodes are in the right spot.

The second surgery to put in the control device may happen the same day or the following day. You'll get general anesthesia, which means you won't be awake or feel any pain during the procedure. Your surgeon places the device under the skin near your collarbone. It will be connected under your skin with the wire from the electrodes.

After Surgery

A few weeks after surgery, you'll go to your doctor's office so they can turn the device on and program it to provide the right amount of electric stimulation to your brain.

The programming of the device will usually take place over several visits to make sure your symptoms are getting better. You'll get a remote to turn your device on and off and check its battery power.

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Pros and Cons of DBS

Your doctor and your family can help you weigh the benefits and drawbacks of deep brain stimulation so you can decide if it's the right move for you. Some things to consider:

Risks. All surgery comes with the chance of complications. There's a chance that some of these things could happen:

Side effects. There's a chance that you could have symptoms after your surgery, like:

  • Numbness or tingling
  • Muscle tightness in your face or arm
  • Speech or balance problems
  • Depression or other mood changes
  • Lightheadedness

Maintenance. You'll need to see your doctor often at first, especially in the first few months, as they adjust the amount of electric pulses you get. You'll also need to get new batteries for your device every few years. Be sure to do that before they run out of power so your treatment doesn't stop.

Limited testing. DBS is new, and there hasn't been much research to check how well it works for schizophrenia. The studies that have been done were very small.

Fewer symptoms. When DBS is successful, your schizophrenia symptoms will get better. That's a huge benefit if you weren't getting relief from other treatments.

Flexibility. DBS can be adjusted over time as your symptoms change. It can also be stopped at any time, unlike medicine, which can take weeks to wear off.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on November 25, 2018

Sources

SOURCES:

National Alliance on Mental Illness: "Mental Health Medications," "Frequently Asked Questions."

National Institute of Mental Health: "Schizophrenia."

Neuropsychiatry: "Treatment-refractory schizophrenia: what is it and what has been done

about it?"

MedlinePlus.gov: "Clozapine."

Mayo Clinic: "Deep Brain Stimulation."

University of Florida Movement Disorders & Neurorestoration Program: "What a Patient Needs to Know About DBS."

Cleveland Clinic: "Deep Brain Stimulation."

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