Programming The Neurostimulator

Programming the neurotransmitter is regarded as one of the most critical facets of deep brain stimulation (DBS) surgery. Let’s learn how it is done in this article

Programming the neurotransmitter is regarded as one of the most critical facets of deep brain stimulation (DBS) surgery. The procedure of DBS involves accurate placement of electrodes or leads in a specific brain region, so that electrical pulses can be sent to those areas of the brain to relieve or control Parkinson’s symptoms. The generation of these pulses is controlled and regulated by a stimulator device just like a heart pacemaker. This is called the neurostimulator.

What Is DBS Programming?

Electric pulses sent from the neurostimulator help to regulate brain activity, correcting or reducing faulty nerve signals that are responsible for symptoms such as tremors and rigidity. Neurostimulators do not come pre-programmed as every patient is unique and programming must be customized to meet the patient’s needs. In fact, programming of the neurostimulator is regarded as one of the main deciding factors in patient outcomes. DBS programming involves adjustments and tweaks to the stimulator settings after surgery and is done with a wireless device or DBS remote. The stimulator settings are carefully calibrated to produce the best results and may also need to be adjusted over a period of time as the condition changes. 

When Does DBS Programming Take Place & How Should I Prepare?

Programming of the neurostimulator is usually scheduled about 10 to 14 days after the surgery and can be done at your Parkinson’s specialist’s clinic. Your Parkinson’s specialist will use the special DBS remote control to program the device and you will be told to make changes in medication dosage after the procedure. 

To prepare for the programming procedure, you will be advised to halt the use of your medications 12 hours in advance of the session. During the programming session, your Parkinson’s specialist will request you to perform specific tasks to assess the best stimulation settings to relieve and reduce symptoms. Remember to carry your DBS remote control device and charger for these programming sessions.

How Long Does It Take To Program The Neurostimulator?

Programming the neurostimulator can be a time consuming and laborious process that requires great skill. With a skilled and experienced Parkinson’s specialist, DBS programming will require at least 3 to 4 visits and it may take as long as 4 to 6 months to find the most effective stimulation settings. 

Keep in mind that as a progressive disease, Parkinson’s symptoms worsen over time, making it necessary to visit your Parkinson’s specialist’s clinic periodically for adjustments to the programming settings. 

What Should One Learn About Using The Programmer?

It’s important to listen closely to what your Parkinson’s specialist says during your visits as you will be provided with detailed instructions after the programming. This will include guidance on turning the neurostimulator on and off at night, if required, making adjustments to the stimulation, selecting programs, and so on. In addition to learning how to use the DBS remote, patients and caregivers will also be given instructions on using a charging unit if the DBS has a rechargeable battery. Usually, a rechargeable DBS battery will need charging for 1 to 2 hours every week. 

While programming visits to your Parkinson’s specialist’s clinic may be inconvenient and time consuming, they are necessary to ensure the best outcomes from DBS. Moreover, these issues in programming are likely to be resolved in the future with advances in remote and internet-based programming.