About Deep Brain Stimulation (DBS) in the Neuroscience Institute

The Deep Brain Stimulation (DBS) Surgery Clinic is held within the Neuroscience Institute at Children’s Hospital Colorado. The clinic, part of the Pediatric Movement Disorders Clinic, evaluates children diagnosed with dystonia (a movement disorder that leads to muscle spasms and abnormal postures) to determine if DBS treatment is right for them.

Team members in the clinic educate families about DBS and discuss treatment outcomes and expectations. Children who have had DBS continue to visit the clinic for device programming of the DBS pulse generator and ongoing treatment management.

What is deep brain stimulation?

Deep brain stimulation (DBS) is a surgical procedure involving the placement of tiny wires into the movement center of the brain. The wires are connected to a pulse generator, most often implanted in the chest, which sends out a steady current to help interrupt the brain activity that is causing abnormal movement. The stimulation allows the brain to better control movement. Learn what to expect by reading Djimon's story which is also a featured article in the Denver Post.

How can deep brain stimulation help my child?

DBS treatment helps manage symptoms of dystonia and can improve a child’s quality of life. The stimulation from the DBS pulse generator is adjustable and can be turned off at any time. The stimulation is customized during clinic visits to achieve the maximum benefit from the stimulation. Children's Colorado has done extensive deep brain stimulation research, which can help you to understand more about how deep brain stimulation can help your child's muscle control issues.

Dystonia symptoms that can be improved with DBS treatment include:

• Muscle spasms
• Twisting
• Involuntary contractions
• Posturing
• Uncontrolled movements

Improvement in quality of life can include:

• A decrease in pain caused by dystonia
• Improved use of assistive devices
• Increased comfort while sitting
• Ability to participate in activities of daily living (dressing, changing, bathing, etc.)

Is deep brain stimulation safe?

The Food and Drug Administration (FDA) approved Medtronic DBS Therapy in 2003 as a Humanitarian Use Device. The FDA reviewed the safety of Medtronic DBS Therapy for dystonia patients, including pediatric patients as young as 7 years old.

What can I expect at my visit to the Deep Brain Stimulation (DBS) Surgery Clinic?

During the initial visit, you and your child will participate in questionnaires, complete quality of life and pain scales, and discuss DBS therapy. In addition, your child will be videotaped during a neurological exam to help collect baseline information on the areas of abnormal movement and tone.

During DBS follow-up visits, the DBS pulse generator will be programmed and medications will be adjusted as needed to address ongoing changes in tone. Learn more about what to expect by reading Djimon's patient journey through a Deep Brain Stimulation surgery.

Why choose Children’s Colorado for deep brain stimulation treatment?

We are the only pediatric DBS program in the Rocky Mountain region

Currently, there are only a handful of pediatric programs in the United States offering DBS surgery and management. Children’s Colorado, in partnership with University of Colorado Hospital, is the only pediatric-specific DBS program in the Rocky Mountain region.

We only care for kids, teens and young adults

Research shows that families who choose a pediatric surgical program (compared to an adult program) have a better experience. Children's Colorado’s DBS Clinic only treats children ages 9 to 18, making us experts when it comes to caring for your child.

A team of experts from multiple pediatric specialties

The DBS Clinic at Children’s Colorado is made up of a team of specialists from many departments all in one place. We work together to care for your child and include you in decision making. The pediatric care team includes:

• Neurosurgeon
• Movement disorder child neurologist
• Neuropsychologist
• Neuroradiologist
• Nurse practitioners and physician assistants
• Rehabilitation specialist
• Physical/occupational/speech therapists
• Kinesiologist
• Nutritionist
• Registered nurse program coordinator
• Child life specialists
• Social worker and family navigator

Advanced technology improves planning before and during surgery

Before surgery, surgeons in the DBS Clinic use images from a 3T MRI. A 3T MRI has a higher resolution that a normal MRI, which provides better DBS target imaging.

During surgery, our neurosurgeon and neurologist use Brainlab, a minimally-invasive 3D imaging software that allows the surgery team to find the best position for the DBS leads inside the brain. We even helped develop the equipment for DBS surgery for the safest and most effective DBS placement possible.

Specific conditions treated by DBS

• Dystonia

Services offered in the Deep Brain Stimulation (DBS) Surgery Clinic

• Dystonia rating evaluation which determines the severity of the disorder (videotaping with consent)
• 3T MRI and functional imaging studies
• Additional leading-edge research imaging techniques
• Neuropsychology evaluation
• Swallow evaluation
• Upper extremity function analysis testing
• Pain evaluation throughout treatment
• Performance measure evaluation for goal attainment
• Rehabilitation consult
• Physical /occupational /speech therapy consult
• Neurosurgery consult
• Nutritional consult
• Psychiatry consult (as needed)

Research

The DBS Surgery Clinic is involved in research about how DBS works in kids with dystonia. Our patients have the opportunity to be involved in advanced treatment and to participate in exciting clinical trials.

Referral Information

We are currently accepting referrals for new patients diagnosed with dystonia to discuss deep brain stimulation as a potential treatment option. Contact the DBS care team in the Neuroscience Institute at Children’s Colorado by:

• Phone: 720-777-4996
• Referral Fax: 720-777-7197
• Email: DBSProgram@childrenscolorado.org