What Should I Know About Treating Parkinson’s With Deep Brain Stimulation (DBS)?

For some people living with Parkinson’s disease, medications eventually become less predictable. Tremors may return between doses, stiffness and slowness may fluctuate, or involuntary movements called dyskinesias may become difficult to control. When medication adjustments are no longer providing consistent symptom control, deep brain stimulation (DBS) may be an option worth discussing with a Parkinson’s specialist.
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Could DBS help you or someone you love regain more predictable “on” time and better control over troublesome movement symptoms? Here’s what you should know before considering this advanced Parkinson’s treatment.

What Is Deep Brain Stimulation?
Deep brain stimulation is a surgical treatment that uses a small implanted device to send electrical signals to specific areas of the brain involved in movement.
Thin electrodes are placed in targeted areas of the brain and connected to a neurostimulator, usually implanted under the skin near the collarbone. The device can then be programmed to help regulate abnormal brain activity associated with Parkinson’s movement symptoms. 
DBS has been used to treat Parkinson’s disease for decades and is an established treatment option for appropriately selected patients.

What Parkinson’s Symptoms Can DBS Help?
DBS is primarily used to treat movement-related symptoms.
It may help reduce:

• Tremor
• Muscle stiffness or rigidity
• Slowness of movement
• Dyskinesia
• Motor fluctuations or “wearing off”
• Certain medication-related movement problems

Symptoms that respond well to levodopa often respond well to DBS, although tremor can sometimes improve with DBS even when it does not respond adequately to levodopa.

Is DBS a Cure for Parkinson’s?
No. DBS does not cure Parkinson’s disease or stop the underlying disease from progressing.
Instead, it is a treatment designed to improve specific symptoms and, for some people, provide more consistent control of movement.
Many people continue taking Parkinson’s medications after DBS, although some may be able to reduce their medication doses. 

Who Might Be a Candidate for DBS?
DBS is not right for everyone with Parkinson’s.
A movement-disorder specialist may consider DBS when a person has a confirmed Parkinson’s diagnosis and continues to experience significant motor symptoms or medication-related complications despite medication adjustments.
Doctors may evaluate:

• How symptoms respond to levodopa
• Tremor, stiffness, and slowness
• Motor fluctuations
• Dyskinesias
• Overall physical health
• Memory and thinking
• Depression and other mental-health concerns
• Ability to undergo surgery
• Available family or care-partner support

A comprehensive evaluation often includes neurological assessment, brain imaging, medication review, and neuropsychological testing. 

When Should Someone Consider DBS?
One important misconception is that a person must wait until Parkinson’s medications completely stop working.
In fact, DBS may be considered when medications still help but become difficult to manage because of wearing-off periods, dyskinesias, or other troublesome fluctuations. 
The timing is highly individual, which is why discussing DBS with a movement-disorder specialist before symptoms become extremely difficult to control may be worthwhile.

What Happens During DBS Surgery?
DBS treatment involves implanting the stimulation system.
The procedure generally involves placing electrodes into carefully selected areas of the brain and connecting them to a neurostimulator implanted beneath the skin. Depending on the approach and medical center, the procedure may involve one or more surgical sessions. 
Brain imaging is used as part of planning and positioning the electrodes.

What Happens After Surgery?
DBS is not simply “turned on” and finished.
After the surgical sites heal, the device is activated and programmed. The medical team adjusts stimulation settings to find the combination that provides the most symptom improvement while minimizing side effects.
Several programming appointments may be needed, particularly during the early months. Follow-up continues over time because symptoms and treatment needs can change. 

What Are the Risks of DBS?
Because DBS involves brain surgery and an implanted medical device, there are potential risks.
Surgical complications can include infection, bleeding, seizures, confusion, or other neurological complications. Stimulation itself can sometimes contribute to problems such as speech changes, balance difficulties, involuntary movements, or other side effects. Many stimulation-related effects can be addressed by changing the device settings, but not every complication is reversible. 
The decision should therefore involve a careful discussion of potential benefits and risks with an experienced DBS team.

What Symptoms May Not Improve With DBS?
DBS is primarily a treatment for certain movement symptoms. It should not be viewed as a treatment for every symptom of Parkinson’s.
For example, symptoms such as mood problems, fatigue, and some walking difficulties may not improve, particularly if they did not previously respond to levodopa. Balance, speech, and swallowing problems can also be challenging and may sometimes worsen with stimulation.
This is why having realistic expectations before surgery is extremely important.

Questions People Ask About Parkinson’s DBS
1. Does DBS stop Parkinson’s from progressing?
No. DBS treats certain symptoms but does not stop the underlying progression of Parkinson’s disease. 
2. Can DBS eliminate tremors?
DBS can significantly reduce tremor in appropriately selected patients. Tremor may respond to DBS even when it does not respond well to levodopa. 
3. Will I still need Parkinson’s medication after DBS?
Usually, yes. Some people can reduce their medication after DBS, but most continue taking some Parkinson’s medications. 
4. Is DBS appropriate for older adults?
Age alone does not automatically exclude someone from consideration. Overall health, cognitive function, symptoms, surgical risk, and individual circumstances are important factors. 
5. How do I find out if DBS is right for me?
The best starting point is a comprehensive evaluation by a neurologist or movement-disorder specialist experienced in DBS.

Conclusion: DBS Is an Option, Not a One-Size-Fits-All Solution
Deep brain stimulation can be a life-changing treatment for some people with Parkinson’s disease, particularly those experiencing troublesome tremor, rigidity, slowness, dyskinesia, or medication fluctuations.
But DBS is not a cure, and it is not right for everyone.
The most important step is learning whether your specific symptoms, health, treatment response, and goals make DBS a reasonable option. A specialized DBS team can help you understand both what the procedure may accomplish and what it cannot.
Most importantly, you don't have to make the decision alone.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.
Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
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To learn more, visit www.paswfl.org and discover the power of support, education, and community.