ABSTRACT
Deep brain stimulation (DBS) is a complex medical treatment. The success of this
intervention depends on a variety of components including proper patient selec-
tion, accurate surgical placement of the electrode, effective programming of the
stimulator and adequate follow-up medication management. While the former
two are one-time events, the latter two are reoccurring interventions over the life-
span of the therapy. As the strength of a chain is determined by its weakest link,
the overall success of DBS is determined by its weakest component as well. In
general, stimulator programming represents the weakest link and does not infre-
quently break the chain, diminishing or eliminating potential benefits of DBS.
Fortunately, programming is a reoccurring event and allows for correction or
reprogramming, and hopefully improved outcome. While individual components
of this therapy are performed by highly trained neurosurgeons and neurologists,
programming is often relegated to health care professionals with inadequate
training and experience. As a result, the full potential benefit of this therapy is
not always attained and the efficacy of DBS is potentially diminished.
