GLOSSARY

Abdomen placement: An alternative location where an IPG may be implanted under the skin, instead of the chest.
Abnormal impedance: A device measurement suggesting the circuit may not be behaving normally, prompting troubleshooting.
Abrupt change: A noticeable shift over hours to days, often linked to a specific event or change.
Absolute contraindication: A situation where a treatment should not be used because the risk is too high.
Abstinence: Not using the substance.
AC (anterior commissure): A small bundle of nerve fibers used as a landmark for stereotactic brain coordinates.
AC PC line: An imaginary line between the anterior commissure and posterior commissure used to create a brain coordinate system.
ACC (anterior cingulate cortex): A brain region involved in the emotional and attention-related experience of pain, sometimes targeted to reduce suffering even if some sensation remains.
Acceptance and commitment therapy (ACT): A therapy approach that builds psychological flexibility by practicing skills like acceptance, values-based action, and mindfulness.
Access wound: The incision site used to reach or place part of the DBS system, such as scalp or chest incisions.
Accidental deactivation: Stimulation being turned off unintentionally, such as by pressing buttons or device interaction.
Accommodation: A change at work that helps a person do their job effectively and safely.
Accommodations trial period: A time-limited test of an accommodation to see if it works in the real world.
Accountability partner: A supportive person who helps you follow through on goals, reminders, or routines.
Achilles tendon tightness: Tightness in the heel cord that can affect gait, sometimes related to dystonia, spasticity, or posture changes.
Acid reflux: Backflow of stomach acid that can cause heartburn or throat symptoms, sometimes affecting swallowing comfort.
Acoustic neuroma: A benign tumor on the nerve for hearing and balance, sometimes relevant in differential diagnosis of dizziness.
Acquired dystonia: Dystonia caused by a known injury or condition, such as stroke, trauma, infection, or medication exposure.
Acquired movement disorder: Abnormal movements that develop after a brain injury, illness, or exposure, rather than from a genetic cause.
Action tremor: Tremor that appears during voluntary movement, like reaching or holding an object.
Activation: The process of turning the DBS system on and setting initial stimulation parameters.
Activation appointment: The clinic visit when DBS stimulation is first turned on after surgery and healing.
Activation day: The first visit where DBS is turned on and initial settings are created.
Active break: A brief break that includes light movement, such as standing, stretching, or walking.
Active contact: A contact or segment currently selected to deliver stimulation.
Activity modification: Changing how, when, or how long you do an activity to reduce symptoms or side effects.
Acute: A short-term or sudden onset issue, often over hours to days.
Acute dystonic reaction: A sudden muscle spasm or abnormal posture, sometimes a medication side effect.
Acute infection: A short-term infection that may require treatment before surgery or before certain procedures.
Acute pain: Pain that starts suddenly and is expected to improve as healing occurs.
Acute stress response: The body’s immediate stress reaction, which can worsen symptoms like tremor or anxiety.
Adaptive DBS (aDBS): DBS that can adjust stimulation based on sensed signals, when supported by a device and approved for a given use.
Adaptive stimulation: Stimulation that changes automatically in response to signals or patterns, rather than staying fixed.
Adhesive patch: A sticky pad used with some charging systems to help hold the charger in the correct spot.
Adherence: Following a treatment plan as intended, such as taking medication on schedule or charging routinely.
Adjunct therapy: A supportive treatment added to DBS, such as medication changes, therapy, or rehabilitation.
Adjustment disorder: Emotional or behavioral symptoms triggered by a major life change, sometimes overlapping with anxiety or depression.
Adjustment period: The early phase after surgery or programming when your body and routines are adapting.
Adjuvant therapy: Another term for adjunct therapy, an added treatment that supports the main therapy.
Advance directive: A legal document describing healthcare wishes, often including a healthcare proxy decision-maker.
Advance care planning: Planning ahead for health decisions, including preferences, documents, and who speaks for you.
Advance notice: A warning or early sign that something is changing, like battery status declining or symptoms drifting.
Adverse event: An unwanted medical event that happens during treatment, whether or not it is caused by the treatment.
Aerobic exercise: Activity that raises heart rate and breathing, like walking or cycling, often supportive for mobility and mood.
Affective symptoms: Emotional symptoms, such as depression, anxiety, irritability, or mood swings.
Afterdischarge: A burst of activity in brain tissue after stimulation ends, relevant in some neurophysiology contexts.
Age-related change: Normal changes that occur with aging, which can affect stamina, cognition, or balance.
Agitation: Restlessness or irritability that can occur from mood changes, medication effects, or stimulation changes.
Agonist: A substance that activates a receptor, such as dopamine agonists stimulating dopamine receptors.
Air travel screening: Security screening processes that may involve scanners or wands, relevant to DBS travel safety planning.
Airport body scanner: A walk-through scanner used in security screening, which may be allowed depending on device guidance.
Alarm symptom: A sign that needs urgent evaluation, such as infection signs, sudden weakness, or severe confusion.
Alert bracelet: A wearable medical ID that identifies an implanted device and important safety details.
Alignment: Positioning the charger so it lines up with the implanted battery for efficient charging.
All-or-nothing cycle: A pattern of overworking on “good days,” then crashing and losing function on following days.
Allergy: An immune reaction to a medicine, latex, adhesive, or other substance, important for anesthesia planning.
Alternative mouse/keyboard: Computer devices designed to reduce strain or improve control when tremor or stiffness is present.
Ambulation: Walking or moving around, often measured in rehabilitation or functional assessments.
Amplitude: The strength of stimulation, often measured in volts or milliamps depending on the system.
Amplitude (DBS): The strength of stimulation.
Amygdala: A brain region involved in emotion and threat processing, sometimes discussed in anxiety and mood circuits.
Anatomical target: The specific brain region chosen for stimulation.
Anesthesia: Medicines used to control pain and awareness during surgery.
Anesthesia evaluation: A pre-op visit where anesthesia staff review health history, airway, medications, allergies, and prior anesthesia experiences.
Anesthetic risk: The potential risk from anesthesia based on health conditions, airway, and procedure complexity.
Ankle-foot orthosis (AFO): A brace used to support ankle stability and improve gait in some neurologic conditions.
Anorexia nervosa: An eating disorder involving restriction, fear of weight gain, and distorted body image, studied in DBS research contexts.
Anosognosia: Reduced awareness of one’s own symptoms, sometimes seen in neurological or psychiatric conditions.
Antagonist: A substance that blocks a receptor, such as certain medications blocking dopamine receptors.
Anterior: Toward the front of the body or brain.
Antibiotic prophylaxis: Antibiotics used to prevent infection, sometimes given around surgery or certain procedures.
Anticoagulant: A medication that reduces blood clotting, sometimes called a blood thinner.
Antiepileptic drug (AED): Another term for antiseizure medication.
Antiparkinsonian medication: Medications used to treat Parkinson’s symptoms, such as levodopa or dopamine agonists.
Antiplatelet: A medication that reduces platelet clumping, often used to lower clot risk, can raise bleeding risk in surgery.
Antiseizure medication: A medication used to reduce seizures, also called antiepileptic drug (AED) or ASM.
Antispasticity medication: Medication used to reduce muscle tightness or spasticity, such as baclofen in some cases.
Anxiety: Excessive worry or fear that can affect sleep, function, and symptom perception, and may shift with treatment changes.
Apnea: A pause in breathing, often discussed in sleep apnea and anesthesia planning.
Apathy: Reduced motivation or emotional “flatness” that can appear with illness changes, stimulation changes, or medication changes.
Appeal: A formal request to review a denial decision for a benefit or claim.
Appetite change: Increased or decreased hunger that can occur with mood, medication, or stimulation effects.
App-based controller: A smartphone or tablet application used to interact with DBS therapy, depending on manufacturer system.
Arrhythmia: An abnormal heart rhythm, relevant to anesthesia planning and some medication decisions.
Artifact: A false signal or distortion in imaging or recordings, sometimes relevant to MRI or device telemetry.
Assistive technology: Tools or software that help someone perform tasks, such as voice dictation or ergonomic equipment.
Asleep DBS: DBS lead placement done under general anesthesia.
Assessment: A structured evaluation of symptoms, function, and goals, often using tests or rating scales.
Ataxia: Poor coordination and balance, often linked to cerebellar dysfunction and sometimes affected by stimulation.
At-home safety plan: Practical steps to reduce risks at home, such as fall prevention strategies and device care routines.
At-will employment: A common US employment arrangement where employment may be ended by employer or employee, with legal exceptions that vary by state and circumstance.
Attachment: A file or document included with a message or record, relevant for record transfer and documentation.
Attention: The ability to focus on a task or information, often assessed in neuropsychological testing.
Auditory cueing: Using sound cues, like a metronome, to support gait or movement timing.
Authorization: Insurance approval for a test, visit, or procedure.
Autonomic symptoms: Symptoms involving automatic body functions like blood pressure, heart rate, sweating, or digestion.
Autoimmune: A process where the immune system attacks the body’s own tissue, sometimes relevant to rare movement disorders.
Awake DBS: DBS lead placement done while the patient can respond during parts of surgery, typically with local anesthesia and sedation.
Awareness: Knowing what is happening in your body and environment, sometimes affected by fatigue, mood, or cognition.
Axial symptoms: Symptoms affecting the trunk and posture, like balance, gait, and speech.

Back-up plan: A practical plan for what to do if symptoms worsen or equipment fails, such as travel backup items or clinic contacts.
Balance: The ability to stay steady when standing or moving, often a key functional focus in DBS care.
Ballism: Violent flinging movements, often linked to injury in motor circuits and sometimes discussed with hemiballismus.
Baseline: Your usual symptom level before a change in stimulation or medication.
Base period: A defined time window used by some benefit programs to calculate eligibility and payment amounts.
Base station: A stand that connects to power and charges the external charger.
Battery: The power source inside the IPG, either rechargeable or non-rechargeable.
Battery depletion: When the implanted pulse generator is running low and can no longer deliver therapy as intended.
Battery estimator: A tool or estimate used to predict remaining battery life based on current settings and usage.
Battery replacement: A maintenance step that may be needed over time for some DBS systems, based on the device type and usage
Battery status: The displayed level of charge for the implant, the external charger, or both.
Behavioral activation: A therapy approach that increases engagement in meaningful activities to support mood and motivation.
Behavioral side effect: A change in behavior, urges, or judgment that may relate to medication, stimulation, or both.
Behavioral variant frontotemporal dementia (bvFTD): A form of frontotemporal dementia marked by changes in personality, behavior, and decision-making.
Benefit: The symptom improvement a person experiences from DBS and related care.
Benefit denial letter: A written notice stating a claim was denied and explaining the reasons and how to appeal.
Best-corrected function: Function measured when supports are optimized, such as with best medication timing or best DBS settings.
Bilateral: On both sides of the body or brain.
Bipolar stimulation: A configuration where current flows between two contacts on the lead, often creating a more focused stimulation field.
Bluetooth: A short-range wireless connection used by some controllers to communicate with the implanted device.
Body-first symptoms: Symptoms that show up physically before cognitive or emotional changes, depending on the condition.
Body scanner: A security device used in airports, often discussed in travel safety planning for implanted devices.
Bowel regimen: A plan to manage constipation, often important in Parkinson’s disease and post-surgery recovery.
Brain fog: A non-medical term people use to describe slow thinking, reduced focus, or mental fatigue.
Brain lesion: An area of damaged brain tissue from stroke, trauma, tumor, infection, or inflammation.
Brain target: The brain region chosen for stimulation, based on diagnosis and symptom goals.
Breakthrough symptom: A symptom that returns despite treatment, sometimes linked to wearing off, stress, or device changes.
Bradykinesia: Slowness of movement, commonly seen in Parkinson’s disease.
Bradyphrenia: Slowness of thinking, sometimes described by patients with Parkinson’s or other conditions.
Bridge prescription: A short-term prescription used to cover a gap, such as during insurance changes.
Bruxism: Teeth grinding or jaw clenching, sometimes related to dystonia, stress, or medication effects.
Burr hole: A small opening made in the skull during surgery to allow lead placement.
Burr hole cover: A cover that may be used to protect the burr hole area and help manage lead stabilization.
Burnout: A work-related phenomenon linked to chronic workplace stress, often involving exhaustion, cynicism or distance, and reduced effectiveness.
Burst stimulation: A patterned stimulation approach sometimes studied in neuromodulation contexts.

Cable: Another term for extension wire or charging cables, depending on context.
Care partner: A person who takes an active, ongoing role in supporting someone’s health and daily life, with an emphasis on teamwork.
Caregiving burden: The load or strain a caregiver experiences, including emotional, physical, time, and financial stress.
Caregiving role drift: When a helper slowly takes on more tasks without a clear plan or agreement.
Carbidopa levodopa: A common Parkinson’s medication combination that replaces dopamine in the brain.
Cardiac clearance: A cardiology review confirming heart-related safety for surgery when needed.
Case for support: A document explaining why a cause matters and why support is needed, relevant in advocacy and nonprofits.
Catheter: A tube used to drain urine or deliver fluids, sometimes used during surgery.
CBIT: A specialized behavioral therapy for tics that teaches awareness and competing responses to reduce tic expression.
CBC (complete blood count): A blood test that checks red blood cells, white blood cells, and platelets.
CBT (cognitive behavioral therapy): A therapy approach that teaches skills to change unhelpful thought and behavior patterns.
Cellulitis: A skin infection that can occur near incision sites or device pockets, requiring evaluation.
Central post-stroke pain: Chronic pain after stroke due to injury in sensory pathways.
Centromedian–parafascicular complex (CM-Pf): A thalamic region studied as a DBS target for Tourette’s syndrome.
Cerebellar: Related to the cerebellum, the brain area involved in coordination and balance.
Cerebellar tremor: A tremor linked to cerebellar damage, often an intention tremor that worsens near a target.
Certificate of medical necessity: A document used by insurers to justify equipment or treatments based on clinical need.
Chest X-ray: An imaging test that can help evaluate lungs and heart size, sometimes ordered pre-op based on history.
Chorea: Involuntary dance-like movements that can affect face, trunk, and limbs.
Choreiform: Having features similar to chorea.
Chronic: Long-lasting or persistent over months or longer.
Chronic neuropathic pain: Long-term pain caused by nerve pathway injury or dysfunction.
Circadian rhythm: The body’s 24-hour timing system that affects sleep, energy, and hormone cycles.
Circuit integrity: Whether the DBS electrical pathway is intact and functioning normally.
Cingulate cortex: A brain region involved in emotion, attention, and pain processing, sometimes targeted in psychosurgery or DBS research.
Cingulotomy: A procedure targeting the cingulate region to reduce the emotional suffering component of pain.
Claim: A formal request for insurance or benefits coverage.
Clearance: A clinician’s confirmation that medical issues are stable enough for surgery, sometimes with recommended precautions.
Clinician letter: A medical provider’s letter describing diagnosis, treatment, and functional limits relevant to work or benefits.
Clinician-led taper: A step-by-step, supervised reduction plan for a medication.
Clinician programmer: A clinician-only device or software used to set up and adjust DBS settings.
Clinical trial: A research study that tests a treatment’s safety and effectiveness in people.
Cognitive behavioral therapy (CBT): A therapy approach that teaches skills to change unhelpful thought and behavior patterns.
Cognitive load: The amount of mental effort a task requires, including attention, memory, and decision-making.
Cognitive reserve: The brain’s ability to cope with damage or disease, influenced by education, activity, and health.
Comorbidity: Another health condition that exists alongside the main diagnosis.
Compassion fatigue: Emotional exhaustion that can occur in caregivers or helpers after prolonged stress and caregiving.
Competing response: A purposeful movement that interrupts a tic and is held until the urge passes.
Complication: An unwanted problem that occurs during or after treatment, such as infection or bleeding.
Compulsion: A repeated behavior or mental act done to lower anxiety or prevent feared outcomes, even when it feels irrational.
Confidential medical information: Medical details that should be stored separately and shared only with people who need it for a work-related reason.
Confidential medical record: Medical information that should be stored separately and shared only with those who need it for work-related reasons.
Confidentiality: Keeping private health information private, unless the person chooses to share it.
Connector block: The portion of the IPG where the extension connects, sometimes called the header.
Contact: A small metal point on the DBS lead used to deliver stimulation.
Contact selection: Choosing which contact or segment is active to change where stimulation is delivered.
Contacts (electrode contacts): The small metal points on the lead tip that deliver stimulation.
Continuity plan: A plan for maintaining medical care during moves, insurance changes, or team transitions.
Contingency management: A treatment approach that uses rewards to support recovery behaviors like negative drug tests.
Contraindication: A reason a treatment should not be used because it may cause harm.
Contralateral: On the opposite side of the body or brain.
Controller: A handheld device or app used to check or manage certain DBS functions, within clinic-set limits.
Coping skill: A practical strategy to manage stress, symptoms, or emotional discomfort.
Cordotomy: A destructive spinal procedure that interrupts pain pathways, sometimes used in severe cancer pain.
Core symptom: The main symptom a treatment is designed to address, such as tremor in essential tremor.
Corticobasal: A rare movement disorder category, sometimes discussed in differential diagnosis.
Craving: A strong urge to use a substance, sometimes triggered by stress, cues, or withdrawal.
CT (computed tomography): A type of imaging that uses X-rays to create cross-sectional pictures.
Cue reactivity: The brain and body response to reminders of the substance, such as seeing paraphernalia or a location associated with use.
CSTC circuit: A brain loop linking cortex, striatum, thalamus, and back to cortex, often discussed in OCD, habit loops, and some tic disorders
Deep Brain Stimulation (DBS): An implanted treatment that delivers electrical stimulation to a targeted brain area to help manage certain symptoms.
DBS (Deep Brain Stimulation): An implanted system that delivers electrical stimulation to specific brain areas to help manage certain symptoms.
DBS center: A clinic or hospital program that evaluates, implants, and manages DBS therapy.
DBS coordinator: A staff member who helps organize appointments, testing, education, and paperwork across the DBS pathway.
DBS eligibility: Whether you meet the criteria a team uses to consider DBS evaluation or implantation.
DBS ID card: A card that identifies your implanted device and key device details for safety and medical settings.
DBS Settings: The programmed parameters that shape stimulation, which can be changed without additional surgery.
DBS Surgery: The procedure to implant the DBS system, performed by a trained surgical team.
DBS Therapy: The full treatment process, including surgery, programming, follow-up, and long-term maintenance.
Decision-support language: Words that help you discuss options and risks without promising outcomes.
Delegation: Assigning specific tasks to specific people, with clear time frames.
Denial: A decision that coverage or benefits will not be provided, often with reasons and appeal rights.
Depression: Persistent low mood or loss of interest that affects functioning, sometimes influenced by disease, medication, or stimulation.
Device recall: An official notice that a device or component has a safety problem requiring action.
Device pocket: The tissue space where the implanted pulse generator sits under the skin.
Diabetes: A condition that affects blood sugar, relevant because high sugar can affect healing and infection risk.
Diathermy: A therapy that uses electromagnetic energy for heating tissue, unsafe with DBS systems.
Diagnosis confidence: How certain the team is about the condition being treated.
Directional lead: A lead design with segmented contacts that can steer stimulation toward specific directions, depending on the system.
Directional stimulation: Using segmented contacts to steer stimulation toward desired tissue and away from side effect areas.
Disability binder: A single organized place, digital or paper, to keep documents for work, insurance, and benefits.
Disclosure: Choosing to share information about a health condition or medical device at work.
Disease progression: The natural change of a condition over time, which DBS does not stop.
Dignity: The felt sense of being respected, seen as whole, and not reduced to symptoms or needs.
Dignity-protecting strategy: A support that reduces shame and helps you meet needs without feeling exposed or judged.
Direct threat: A legal concept describing a significant safety risk that cannot be reduced with reasonable steps.
Directional stimulation: Using segmented contacts to steer stimulation toward desired tissue and away from side effect areas.
Dopamine agonist: Parkinson’s medications that stimulate dopamine receptors, examples include pramipexole, ropinirole, rotigotine, apomorphine.
Dopamine agonist withdrawal syndrome: A withdrawal state that can occur when dopamine agonists are reduced, even if reduction is medically appropriate.
Dopaminergic: Related to dopamine, the brain chemical involved in movement, motivation, and reward.
Dopaminergic medication: Medication affecting dopamine, commonly used in Parkinson’s.
Dose response: The relationship between a setting change and symptom change.
Dose timing: The schedule of when medication is taken during the day.
Dyskinesia: Involuntary movements, often related to dopaminergic medication exposure in Parkinson’s disease.
Dystonia: Sustained or intermittent muscle contractions causing abnormal postures or movements.
EEOC: The US agency that enforces federal employment discrimination laws.
EKG (ECG): A test that measures heart rhythm and electrical activity.
Electrode: Another term used for the DBS lead, especially the portion that delivers stimulation in the brain.
Electromagnetic interference (EMI): External electromagnetic energy that can interfere with electronic devices, including implanted medical devices.
Elimination period: The waiting period before disability insurance benefits begin, based on the plan’s rules.
Emergency contact: A person listed to be called in urgent situations, often included in medical records.
Endogenous opioids: Natural pain-relieving chemicals made by the body, often discussed in relation to PAG/PVG stimulation.
Energy conservation: Practical ways to do tasks using less effort, fewer steps, and smarter setup.
Energy map: A simple record of what drains energy and what restores it, across days.
Energy pacing: Planning activity and rest to avoid overexertion and support consistent function.
Epilepsy center: A specialized program that evaluates seizures, treatments, and advanced options like surgery or neuromodulation.
ERISA: A federal law that often governs employer-sponsored benefit plans, including many disability insurance plans, and sets rules for claims and appeals.
ERP (exposure and response prevention): A therapy for OCD where a person faces triggers while practicing not doing compulsions, helping the brain learn distress can fade without rituals.
Essential functions: The core duties of a job that are fundamental to the position.
ET (Essential tremor): A tremor disorder, commonly of hands, often action tremor.
Event marker: A patient-logged note (symptom, medication, side effect) used to interpret trends.
Evaluation: A structured process to understand diagnosis, symptom pattern, goals, benefits, and risks.
Evidence log: A dated list of symptoms and functional limits linked to tasks and outcomes.
Executive function: Skills that help you plan, start, organize, and finish tasks.
Exposure and response prevention (ERP): A therapy for OCD where a person faces triggers while practicing not doing compulsions, helping the brain learn distress can fade without rituals.
Extension: The insulated wire connecting brain lead to the generator in chest or abdomen.
Extension (extension wire, extension lead): The insulated wire that connects the brain lead to the IPG under the skin.
External charger: The device you place over the implant to recharge it.
External equipment: The charger, cables, base station, and wearable accessories used for charging.
FMLA: A US law that may provide eligible workers job-protected leave for certain medical and family reasons.
FMLA (Family and Medical Leave Act): A US law that may provide job-protected leave for eligible employees for certain family and medical reasons.
Fasting: Not eating or drinking for a specific time before anesthesia, based on clinic instructions.
Fatigue: A sense of exhaustion that can be physical, mental, or both, and can limit activity even when motivation is present.
Feeding tube: A tube used to deliver nutrition when swallowing is unsafe, sometimes relevant in advanced neurologic disease.
Firmware: Internal device software that controls how hardware behaves.
Fixed DBS (conventional DBS): Stimulation delivered continuously at set parameters.
Flare: A temporary worsening of symptoms, sometimes linked to stress, infection, sleep loss, or treatment drift.
Follow-up: Ongoing clinic care after a procedure or treatment change.
Frequency (DBS): How many pulses per second are delivered.
Frequency (Hz): How often pulses are delivered per second.
Functional disability: When symptoms interfere with daily activities in meaningful ways.
Functional limitation: A restriction in what you can do safely or reliably, like standing, concentrating, or using fine motor skills.
Function log: A brief diary linking symptoms and fatigue to tasks and outcomes, used for pattern-finding.
Function-based documentation: A clinician note describing work limitations and helpful supports, without unnecessary diagnosis details.
Gait: The pattern of walking, including speed, balance, and step size.
Generator: Another term for IPG, the implanted power source and electronics.
GPi (Globus Pallidus internus): A common DBS target for Parkinson’s and dystonia.
Good day, bad day pattern: The real-life variability of symptoms and function across days, often important in disability documentation.
Goal setting: Naming the daily life changes you want most, then matching therapies to those goals.
General anesthesia: A controlled state of unconsciousness, you are fully asleep and not aware during surgery.
Hardware: The implanted parts of DBS, including leads, extension wires, and the neurostimulator.
Hardware complication: A device-related issue such as lead fracture, extension problem, abnormal impedance, or battery failure.
Header: The part of the IPG where leads or extensions connect.
Heat warning: A sign that the charger or skin area is getting too warm.
Hemorrhage: Bleeding, including intracranial hemorrhage as a rare but serious DBS surgical risk.
Humanitarian Device Exemption (HDE): FDA pathway for devices intended to treat or diagnose rare conditions, different from PMA.
HR (Human Resources): The workplace department that often manages leave, benefits, and accommodation processes.
Hypokinetic dysarthria: A common Parkinson’s-related speech pattern that can include quiet voice, imprecise sounds, and rushed speech.
Hypomania: A milder form of mania, with elevated or irritable mood, less need for sleep, and increased activity or risk-taking.
Hypophonia: A voice that is softer than intended or harder to hear.
Hypothalamus: A deep brain region involved in circadian timing and autonomic regulation, implicated in cluster headache networks.
Hypothalamus (posteromedial or posterior hypothalamus): A deep region involved in arousal and stress responses, studied as a DBS target in severe refractory aggression.

I-statement: A way to describe impact without blame, for example, “I feel scared when spending spikes.”
ICB (Impulsive-compulsive behavior): A broad term for reward-driven repetitive behaviors in Parkinson’s disease.
ICD (Impulse control disorder): A pattern of urges and behaviors that are hard to resist and cause harm, such as gambling or shopping.
ICE: Short for “In Case of Emergency,” commonly used to label emergency contacts or numbers.
ICU: Intensive care unit, a higher-monitoring hospital unit for patients who need closer observation.
ID band: A wearable hospital band used for identification and safety.
ID card (DBS): A card that identifies the implanted device and key details, useful in medical and travel settings.
Identity shift: A change in how someone experiences themselves after symptom or circuit changes, sometimes discussed in DBS contexts.
Idiopathic: Without a clearly identified cause.
Idle tremor: A term sometimes used for tremor that appears when a limb is not being used.
Illness anxiety: High worry about health that can amplify symptom monitoring and distress.
Imaging: Pictures of the body, like MRI or CT, used to guide diagnosis and surgery.
Imaging artifact: A distortion or false signal on a scan, sometimes caused by metal or device components.
Imaging clearance: Confirmation that a scan can be done safely with a device, based on manufacturer rules and clinical protocol.
Immediate post-op period: The first days to weeks after surgery when recovery and wound care are the focus.
Immigration medical record request: A request for records used for immigration or travel documentation.
Immobility risk: Increased health risk from reduced movement, such as blood clots, stiffness, or deconditioning.
Impact statement: A short description of how symptoms affect daily life, often used in documentation.
Impedance: A measurement of resistance in the DBS electrical circuit, used to help check system integrity.
Impedance check: A device test that measures whether the stimulation pathway is functioning normally.
Implant: A device placed inside the body.
Implant date: The date the DBS system, or a component, was implanted.
Implant site: The location in the body where a device component is placed, such as the IPG pocket.
Implant site (pocket): The space under the skin where the IPG is placed, most often in the upper chest.
Implanted brain stimulator: A plain-language phrase for the implanted DBS system, especially the IPG and connected wires.
Implanted device registry: A record system tracking implanted devices for safety and follow-up.
Implanted pulse generator: Another term for IPG, the implanted battery and electronics.
Implantable Pulse Generator (IPG): The implanted device that contains the battery and electronics that generate stimulation pulses, also called a neurostimulator.
Implantation: The act of placing an implant into the body.
Implied consent: Consent assumed from circumstances, generally not used for invasive procedures like DBS.
Impulse control: The ability to pause, evaluate consequences, and choose actions aligned with goals and values.
Impulse control change: New or increased urges that feel hard to resist, sometimes linked to medications, disease circuits, or stimulation settings.
Impulse spending: Unplanned or excessive spending driven by urges rather than budgeting.
Impulsivity: Acting quickly without enough consideration of consequences.
In-network: Providers or facilities that have contracts with an insurance plan, often lower cost.
In-office interrogation: A clinic device check where the team reads device data and status.
In-person programming: DBS setting adjustments done in clinic.
In-the-moment coping: Skills used during acute distress, such as breathing, grounding, or stepping away.
Inadequate response: When a treatment trial does not provide meaningful improvement.
Inattentive symptoms: Attention problems that are more about distractibility than hyperactivity.
Incentive: A reward or benefit used to encourage a behavior, relevant in contingency management.
Incision: A surgical cut in the skin.
Incision care: Steps to keep a surgical wound clean and healing properly.
Incision infection: Infection at the skin incision site, needing evaluation and treatment.
Incision site: The area where surgery was performed, such as scalp or chest.
Inclusion criteria: The features required to participate in a clinical trial.
Incontinence: Loss of bladder control, sometimes relevant to neurologic conditions and care planning.
Independent review: A neutral review process, such as insurance appeal review or IRB oversight.
Indication: The condition or symptom a treatment is intended to address.
Induced dyskinesia: Dyskinesia triggered by medication or stimulation changes.
Induction (anesthesia): The start of general anesthesia.
Infection: Bacterial involvement of skin or hardware, a known risk with implanted devices.
Infection signs: Redness, warmth, swelling, drainage, fever, or increasing pain at a device site.
Infection workup: Evaluation steps for possible infection, often labs and imaging, plus exam.
Inferior: Lower or below in anatomy.
Inflammation: Swelling and immune activity in tissue, which can affect symptoms and healing.
Inflammatory marker: A lab value that can rise with infection or inflammation.
Informed consent: A process ensuring a person understands benefits, risks, alternatives, and uncertainties before choosing a procedure.
Information processing speed: How quickly someone can take in and respond to information, often tested in neuropsychology.
Infusion therapy: Continuous medication delivery used in some movement disorders and pain conditions.
Initial programming: Early DBS visits when settings are first created and adjusted.
Initial response: The early improvement or change seen after starting a therapy.
Injection site reaction: Redness, swelling, or pain where an injection was given.
Injury prevention: Steps that reduce risk of falls, burns, cuts, or strain.
Injury-triggered symptoms: Symptoms that worsen after a fall, strain, or trauma.
In-network exception: A plan allowing out-of-network care to be covered as in-network under certain conditions.
Insomnia: Difficulty falling asleep, staying asleep, or waking too early.
Insurance appeal: A formal request for the insurer to reconsider a denial.
Insurance authorization: Plan approval needed before certain tests, visits, or procedures are covered.
Insurance change: Switching insurance plans, often affecting provider access and approvals.
Insurance denial: A decision that a service will not be covered, often with stated reasons and appeal rights.
Insurance plan document: The written rules describing what a plan covers and how.
Insurance portal: An online system for plan members to view benefits and claims.
Insula: A brain region involved in body awareness and the felt experience of pain and emotions.
Intake form: A questionnaire completed before a visit that captures history and symptoms.
Intention tremor: Tremor that worsens as you get closer to a target during reaching, often linked to cerebellar dysfunction.
Intensity: How strong a symptom feels, such as pain severity or tremor amplitude.
Interference: The way symptoms disrupt daily function, sleep, work, or relationships.
Interim plan: A temporary plan to cover a gap, such as during insurance transitions.
Internal capsule: A major fiber pathway connecting deep brain regions to the cortex, relevant to DBS targeting and side effects.
Interoception: The sense of internal body states, like heartbeat, hunger, or tension.
Interpersonal stress: Relationship stress that can worsen symptoms and coping.
Interruption strategy: A step used to pause an escalating symptom cycle, like stepping away or changing posture.
Intervention: Any treatment or action used to address symptoms.
Intraoperative: During surgery.
Intraoperative imaging: Scans done during surgery to confirm lead placement.
Intraoperative testing: Testing during surgery to check effects and side effects of placement.
Intracranial: Inside the skull.
Intracranial hemorrhage: Bleeding inside the skull, a rare but serious risk of DBS surgery.
Intrathecal pump: A device that delivers medication into spinal fluid to treat severe pain or spasticity.
Intravenous (IV): Delivery into a vein, used for fluids, medicines, or anesthesia.
Intrusive thought: An unwanted thought or image that enters the mind, common in OCD and anxiety.
Involuntary movement: Movement that happens without conscious control, such as tremor, tics, chorea, or dyskinesia.
IPG: Short for implantable pulse generator, the implanted battery and electronics.
IPG pocket: The tissue space where the IPG sits under the skin.
IPG replacement: A procedure to replace the implanted battery device when depleted or malfunctioning.
IPG site discomfort: Pain or irritation at the implanted battery location.
IRB (Institutional Review Board): A committee that oversees research ethics and participant protection.
Irritability: Feeling easily annoyed or short-tempered, sometimes influenced by stress, mood, medications, or stimulation.
Ischemic stroke: Stroke caused by blocked blood flow to part of the brain.
Isometric tremor: Tremor that appears when muscles tense against resistance without movement.
Isolation: Reduced social contact, often worsening mood and coping in chronic illness.
ITB (intrathecal baclofen): Baclofen delivered into spinal fluid, typically by an implanted pump.

Jargon: Specialized language that can be confusing without explanation.
Jaw clenching: Tightening of jaw muscles, sometimes a dystonia feature or stress response.
Jitteriness: A shaky, keyed-up feeling, sometimes from anxiety, medications, or stimulation effects.
Job accommodation: A change at work that helps a person perform essential functions safely.
Job protection: Legal or policy protections that reduce risk of losing a job during medical leave or disability.

Kinesigenic: Triggered by movement, often used in paroxysmal dyskinesia subtypes.
Kinetic tremor: Tremor that appears during voluntary movement.
Kinesiology tape: Elastic tape sometimes used for support or proprioceptive cueing, not a DBS treatment.
Knee buckling: Sudden giving way at the knees, raising fall risk.
Knotting (stitches): A part of suturing technique, sometimes relevant to wound healing discussion.

Lab work: Blood tests used to assess infection, anemia, clotting, and overall health.
Labeling (device): Manufacturer rules for device use, such as MRI conditions.
Labile mood: Mood that shifts quickly or feels unstable.
Lacrimation: Tearing from the eye, often seen in cluster headache attacks.
Lag time: The delay between a change and its full effect, common in programming or medication adjustments.
Lead: A thin insulated wire placed in the brain target to deliver DBS stimulation.
Lead (DBS lead): The thin insulated wire implanted in the brain, with contacts at the tip.
Lead fracture: A break in the lead or extension wire, often causing loss of benefit or abnormal impedance.
Lead migration: Movement of the lead from its intended position, which can reduce benefit or change side effects.
Lead-only system: A configuration where only certain DBS components are present, relevant to some MRI labeling.
Lead placement: The surgical positioning of the DBS lead within the brain.
Lead revision: Surgery to reposition or replace a lead if placement or function is not adequate.
Lead tip: The end of the lead that contains contacts positioned at the brain target.
Learning curve: The period of getting used to new routines, such as charging or controller use.
Left-right asymmetry: Symptoms that affect one side more than the other.
Legal standard: The rule or threshold used to make a decision, such as in disability claims.
Lesion: An area of damaged tissue in the brain or body.
Lesioning procedure: A treatment that permanently disrupts a brain pathway, unlike adjustable DBS.
Lethargy: Low energy and slowed activity, sometimes linked to mood, sleep, or medication effects.
Levodopa: A Parkinson’s medication converted into dopamine in the brain.
Levodopa challenge: A test comparing symptoms off and on medication to assess responsiveness.
Liability: Legal responsibility, sometimes relevant in workplace accommodations.
Light sensitivity: Discomfort from light, sometimes part of headache disorders.
Limits (controller): The boundaries set by the clinic for what a patient controller can change.
Limbic circuit: Brain circuits involved in emotion, reward, and motivation.
Limbic side effect: Mood or emotional changes that may relate to stimulation spreading to limbic pathways.
Line of therapy: A step in a treatment sequence, such as first-line, second-line, third-line.
Linkage (records): Making sure reports, images, and notes are connected in a single accessible medical record.
Literature review: A summary of published research, often used in rare DBS indications.
Living will: A legal document expressing medical preferences when a person cannot speak for themselves.
Load (care burden): The time, emotional, and physical effort required for care.
Local anesthesia: Numbing medicine used to reduce pain during a procedure.
Localization: Identifying the precise brain target location.
Long-term follow-up: Ongoing care across months and years after implantation.
Long-term maintenance: Routine device checks, battery management, and symptom monitoring over time.
Loss of benefit: When a therapy seems to stop helping as much, prompting troubleshooting.
Low battery warning: A device alert that battery charge is getting low.
Low blood pressure: Blood pressure that is too low, sometimes causing dizziness or fainting.
Low-frequency stimulation: DBS settings using a lower pulse rate, sometimes used for specific symptom patterns.
Lump (pocket swelling): A swelling or bulge near the IPG site, needing evaluation if new or painful.

Maintenance programming: Programming sessions done after the initial optimization phase.
Major depression: A mood disorder with persistent low mood or loss of interest plus other symptoms affecting function.
Malfunction: When a device does not work as intended.
Magnetic field: The force used in MRI and present in some security systems, relevant to device rules.
Magnet mode: A device behavior triggered by a magnet in some implant systems, depending on model.
Magnet safety: Guidelines about avoiding strong magnets near implants.
MAO-B inhibitor: A Parkinson’s medication class that slows dopamine breakdown.
Masking: Hiding symptoms or distress to appear “fine,” often increasing internal strain.
Maximum tolerable dose: The highest medication dose a person can take before side effects become too limiting.
Medical clearance: A clinician’s confirmation that health issues are stable enough for surgery.
Medical device: A product used to diagnose or treat health conditions, including DBS systems.
Medical ID: A bracelet, necklace, or card that communicates critical health information.
Medical necessity: The justification that a service is needed for health, used in insurance decisions.
Medical record request: A request to transfer or obtain medical records.
Medication adjustment: A change to dose, timing, or type of medication.
Medication holiday: A planned pause of a medication, used cautiously and under supervision when relevant.
Medication-induced parkinsonism: Parkinson-like symptoms caused by dopamine-blocking medications.
Medication reconciliation: A careful review to confirm the correct medication list.
Medication refractory: Symptoms remain severe despite appropriate trials of standard medications.
Medication side effect: An unwanted effect caused by a medication.
Medication timing: When doses are taken during the day, often critical in movement disorders.
Memory complaint: A person’s report of memory problems, which may or may not match testing results.
MER (microelectrode recording): A technique used in some DBS surgeries to record brain signals and refine targeting.
Meta-analysis: A statistical method combining results from multiple studies.
Microlesion effect: Temporary symptom changes after lead placement, before stimulation starts.
Midbrain: The upper part of the brainstem, involved in movement pathways and arousal.
Migraine: A headache disorder with attacks that can include head pain, light sensitivity, nausea, and neurologic symptoms.
Mild cognitive impairment (MCI): Measurable cognitive change that is greater than expected but not severe enough to be dementia.
Mindfulness: A skill of noticing thoughts and sensations without immediately reacting.
Mini-mental status exam (MMSE): A brief cognitive screen, less detailed than full neuropsychological testing.
Mixed tremor: Tremor with multiple components, such as rest plus action tremor.
Model number: A device identifier used to confirm labeling rules and compatibility.
Mood drift: Gradual changes in mood over time, sometimes influenced by illness, life stress, medication, or stimulation.
Mood stability: The ability to maintain a consistent mood without large swings.
Motor complication: Movement-related problems like dyskinesia, wearing off, freezing, or falls.
Motor cortex: The brain’s movement control area on the outer surface.
Motor fluctuation: Swings between better and worse movement as medications wear on and off.
Motor outcome: A measure of movement change after treatment, such as tremor rating.
Movement disorder specialist: A neurologist with advanced training in movement conditions and DBS.
MRI: Magnetic resonance imaging, a scan using magnets and radio waves to create images.
MRI conditional: A label meaning MRI can be done only under specific conditions listed by the manufacturer.
MRI mode: A device setting used for MRI safety in some systems, following manufacturer rules.
MRI safety: The specific rules for whether and how an MRI can be done with a DBS system, which depends on the device and clinical protocols.
MS (multiple sclerosis): An immune-related condition that causes lesions in the brain and spinal cord and can affect movement and sensation.
Multidisciplinary care: Coordinated care across specialties, such as neurology, neurosurgery, psychiatry, and rehab.
Multifocal symptoms: Symptoms affecting multiple body regions.
Myoclonus: Sudden brief muscle jerks, sometimes part of movement disorders.
Myoclonus-dystonia: A condition combining myoclonus and dystonia, sometimes treated with DBS in severe cases.
N-of-1 trial: A structured trial in a single person to test an intervention’s effect.
NAc (nucleus accumbens): A reward and motivation hub studied as a DBS target in addiction and compulsive behaviors.
Narrative note: A clinician or patient note describing history and impact in story form.
Nasal congestion: Blocked or stuffy nose, often part of cluster headache autonomic symptoms.
Nausea: A feeling of sickness or urge to vomit, common with some medications.
Negative symptom: A symptom involving loss of function, like reduced motivation or reduced facial expression.
Neuroacanthocytosis: A group of rare disorders involving abnormal red blood cells and neurologic symptoms, often with chorea.
Neurodegenerative: A condition involving progressive loss of nerve cells over time.
Neuroimaging: Imaging of the brain, such as MRI or CT.
Neurology: The medical specialty focused on the nervous system.
Neuromodulation: Treatments that change nerve or brain activity, often using electrical stimulation.
Neuropsychological evaluation: Testing and assessment of cognition and mood to guide DBS decisions and safety.
Neuropsychological testing: Standardized tests of memory, attention, executive function, and mood.
Neurostimulator: Another term for the implanted pulse generator, the battery and electronics.
Neurostimulation: A group of treatments that use electrical stimulation to change nerve or brain activity.
Neurotransmitter: A chemical messenger in the brain, like dopamine or serotonin.
Night shift effect: Symptom changes linked to altered sleep and circadian rhythm, relevant to tremor and mood.
Nociceptive pain: Pain from tissue injury or inflammation.
Noise (signal): Unwanted interference in device readings or recordings.
Non-motor symptoms: Symptoms not directly about movement, such as sleep, mood, constipation, or cognition.
Non-rechargeable IPG: An implanted battery that is replaced when depleted.
Non-responder: A person who does not reach meaningful improvement after treatment.
Noninvasive therapy: Treatments that do not involve implants or surgery, such as medication or therapy.
Normalization: Adjusting to symptoms and routines until they feel like a new baseline.
NPO: Nothing by mouth, pre-surgery instruction to avoid eating or drinking.
Nurse coordinator: A clinician who helps manage appointments, education, and care coordination.

Objective measure: A measure observed or tested, such as tremor rating scale score.
Obsession: An intrusive unwanted thought, image, or urge that causes distress.
Obsessive-compulsive disorder (OCD): A condition involving obsessions and compulsions that interfere with life.
Occupational therapy (OT): Therapy focused on daily activities, adaptations, and tools to increase independence.
Off-label: Use of a device or treatment for a condition not specifically approved on the label.
Off period: A time when Parkinson’s medications are not working well and symptoms return.
Office interrogation: A clinic device check that reads implant status and settings.
Olfaction change: Changes in sense of smell, common in Parkinson’s disease.
On period: A time when Parkinson’s medications are working and movement is easier.
Onboarding (DBS): The early period of learning device routines, follow-up schedules, and safety basics.
Open-label study: A study where participants and researchers know which treatment is being given.
Optimization: The process of adjusting stimulation and medications to find the best balance of benefit and side effects.
Orthostatic: Related to standing upright.
Orthostatic tremor: Fast tremor felt mainly when standing, improving with walking or sitting.
Outcome measure: A way to track change, such as function, symptom rating, or quality of life.
Out-of-network: Providers not contracted with an insurance plan, often higher cost.
Overstimulation: Stimulation settings that are too strong for the person, causing side effects or worse function.
Overuse injury: Injury from repeating strain or movement, sometimes worsened by tremor or dystonia.

PAG (periaqueductal gray): A midbrain region involved in the body’s pain-control system, studied in pain DBS.
Pain modulation: The nervous system’s ability to turn pain signals up or down.
Pain network: Brain regions and connections that shape pain sensation and suffering.
Pain processing: How the brain interprets and responds to pain signals.
Pallidal: Related to the globus pallidus region.
Pallidotomy: A lesioning procedure in the globus pallidus region, sometimes used for movement symptoms.
Palliative care: Specialized care focused on symptom relief and quality of life, alongside other treatments.
Panic attack: A sudden surge of intense fear with physical symptoms, sometimes overlapping with “off” anxiety.
Paradoxical response: An unexpected response, such as worsening when improvement is expected.
Paroxysmal: Sudden, episodic, coming in attacks.
Paroxysmal dyskinesia: Episodes of involuntary movements that come and go, often with specific triggers.
Passive range of motion: Movement of a limb done by another person or gravity, used in therapy.
Patient controller: A handheld device or app that lets a person check battery and manage limited functions within clinic-set limits.
Patient-reported outcome: The person’s report of how symptoms affect daily life, used to guide care.
Pattern recognition: Noticing repeating symptom trends, triggers, and timing to guide decisions.
Paresthesia: Tingling or pins-and-needles sensations, sometimes caused by stimulation spread.
Parkinsonism: A set of symptoms that look like Parkinson’s disease, with multiple possible causes.
Parkinson’s disease (PD): A progressive disorder commonly causing tremor, stiffness, slowness, and gait changes.
Parkinson’s psychosis: Hallucinations or delusions occurring in Parkinson’s disease, often influenced by medications and disease changes.
Partial response: Some improvement, but not enough to meet goals.
Partner support: Practical and emotional support from a spouse or trusted person.
Pathway: A nerve route or circuit that carries signals.
Payer: The insurance company or plan paying for care.
PBM: Pharmacy benefit manager, an organization that manages medication coverage.
PC (posterior commissure): A brain landmark used with the AC to create stereotactic coordinates.
PCP: Primary care provider, the clinician who manages general health.
PCP clearance: A primary care review indicating health is stable for a procedure.
PD: Abbreviation for Parkinson’s disease.
Peer support: Help from others with shared experience, such as support groups.
Periorbital pain: Pain around or behind the eye, common in cluster headache attacks.
Peripheral nerve: A nerve outside the brain and spinal cord.
Peripheral neuropathy: Nerve damage in the body causing numbness, tingling, or pain.
Perseveration: Getting stuck on a thought or behavior, sometimes seen in certain neurologic conditions.
Personal baseline: The usual symptom level for an individual when stable.
Personality change: A shift in typical behavior or emotional style, sometimes due to disease, stress, or stimulation effects.
Phantom limb pain: Pain felt as coming from a missing limb after amputation.
Phantom sensation: Non-painful feeling that a missing limb is still present.
Phase angle (charging): A measure used by some systems to align charging efficiently.
Pharmacist review: A medication review for interactions, dosing, and safety.
Photophobia: Light sensitivity, common in migraine and some headache disorders.
Physical therapy (PT): Therapy focused on strength, balance, gait, and safer movement strategies.
Physician letter: A clinician letter describing diagnosis, treatment, and functional limits.
Pitfall: A common mistake or risk, like charging routines slipping or missed follow-up.
Placebo effect: Improvement related to expectations and context, not only the active treatment.
Planned “off” evaluation: A structured assessment when medication is held to evaluate baseline symptoms.
Policy language: Terms used in insurance and benefits documents that define coverage and rules.
Polypharmacy: Taking many medications, raising interaction and side-effect risk.
Post-op: After surgery.
Post-op confusion: Temporary confusion after surgery, sometimes related to delirium.
Post-operative care: Wound care, restrictions, and monitoring after surgery.
Posterior: Toward the back of the body or brain.
Posterior hypothalamus: A target area studied for refractory cluster headache and severe aggression in select research contexts.
Postural tremor: Tremor that appears while holding a position against gravity.
PPS: A common abbreviation for private pay or patient payment, depending on context.
Preadmission testing: Pre-surgery testing, often labs and EKG, to reduce anesthesia risk.
Predetermination: An insurer decision made before a service is provided, often for high-cost care.
Predictable wearing off: A pattern where medication effects fade on a consistent schedule.
Premonitory urge: A rising internal feeling that often occurs before a tic.
Pre-op: Before surgery.
Pre-op instructions: Guidance about fasting, medications, and preparation before surgery.
Preauthorization: Insurance approval needed before certain services are covered.
Prescription refill: Renewing a medication supply.
Pressure sore: Skin breakdown from prolonged pressure, a risk with immobility.
Primary care: General medical care focused on whole-body health.
Primary endpoint: The main outcome a study is designed to measure.
Primary symptom: The most prominent symptom driving disability, such as tremor or pain.
Probation period: A trial period at work, sometimes affecting benefits eligibility.
Procedure code: A billing code used for insurance claims.
Process note: A note describing steps taken, such as appeals or symptom tracking.
Processing speed: How quickly someone can think through and respond to information.
Program: A saved set of DBS settings that can be selected within clinic-set limits.
Programming: Adjusting DBS settings over time to balance symptom benefit and side effects.
Programming burden: The number of visits and adjustments needed, often higher in complex conditions.
Programming session: A clinic visit focused on adjusting DBS settings.
Progression: The natural course of a condition over time, which DBS may not stop.
Projection: Estimating future needs, such as battery replacement timing.
Proprioception: The sense of body position in space, important for balance and coordination.
Proprioceptive cue: A touch or positioning cue that helps the brain sense movement and posture.
Protection plan: A plan to reduce risk, such as fall prevention or infection prevention.
Provider directory: A list of clinicians covered by an insurance plan.
Psychiatric clearance: A mental health assessment confirming stability for surgery and DBS follow-up.
Psychiatric comorbidity: Mental health conditions occurring alongside neurologic symptoms, such as anxiety or depression.
Psychological flexibility: The ability to stay aligned with values even when symptoms or distress are present.
Psychotherapy: Talk therapy aimed at improving coping, mood, and behavior patterns.
PVG (periventricular gray): A region near PAG involved in pain modulation and endogenous pain relief pathways.

“Off” state: A planned period when certain medications have been held long enough to evaluate baseline symptoms with less medication effect, based on clinic instructions.
“Off” time: Time when Parkinson’s symptoms return as medication effect fades.
“On” state: The period after taking medication when symptoms are measured again to see how much they improve.
“On” time: Time when Parkinson’s medications are working well and movement is easier.

QR code medical ID: A medical ID item that includes a scannable code linked to a digital medical profile.
Quality of life: A broad measure of well-being.
Quality of life measures: Questionnaires that capture daily function.
QUIP: Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease.
QUIP-RS: A rating scale used to measure severity of impulsive-compulsive symptoms over time.

Radiation-related pain: Pain related to radiation effects on tissues or nerves.
Radiologist: A physician who interprets imaging studies and oversees imaging safety.
Radiology technologist: The professional who performs the scan and operates imaging equipment.
Ramp: A gradual increase or decrease of stimulation to improve comfort during changes.
Ramping: Gradually increasing stimulation over time to improve comfort and reduce side effects.
Randomized trial: A study design where people are assigned by chance to different treatments to reduce bias.
Rating scale: A standardized score or category used to summarize results in a consistent way.
Re-optimization: A later phase of programming when symptoms drift or life changes.
Re-optimization (tune-up): A later round of programming changes when symptoms drift.
Readmission: Returning to the hospital soon after discharge.
Realistic expectations: A shared, honest understanding that DBS outcomes vary.
Reasonable accommodation: A work change that helps a qualified person with a disability perform essential job duties.
Reassignment: Moving to a vacant position you are qualified for.
Rebound: Symptoms returning strongly after therapy decreases.
Recharge cycle: The interval between charging sessions for rechargeable generators.
Recharge routine: Your regular pattern for charging.
Recharge schedule: Your planned timing for charging sessions.
Recharge-free: A generator that does not require charging.
Rechargeable: A battery type designed to be recharged through the skin.
Rechargeable DBS: An IPG designed to be charged regularly through the skin.
Rechargeable IPG: An IPG that is recharged at home through the skin.
Rechargeable neurostimulator: A DBS battery designed to be recharged through the skin.
Recharger: Another word some manufacturers use for the external charger.
Recharging routine: The regular schedule needed for rechargeable DBS batteries.
Recommended replacement time (RRT): A manufacturer term that indicates replacement is recommended.
Record transfer: Sending medical records from one clinic to another.
Records release: Permission to share medical records with another provider or organization.
Recruitment (trial): Enrolling participants in a clinical trial.
Recovery: The healing period after surgery and the adjustment back to daily life.
Recovery timeline: The expected sequence of healing and functional return after surgery.
Red flags: Warning signs that need urgent evaluation.
Red nucleus: A midbrain structure involved in movement pathways.
Reference letter: A letter describing function or support needs, often used for documentation.
Referral: A request for evaluation by another clinician or specialty.
Refractory: Not responding well enough to standard treatments.
Refractory chronic cluster headache: Chronic cluster headache that remains severe despite multiple appropriate treatments.
Refractory pain: Pain that remains severe despite appropriate trials of standard treatments.
Regression to the mean: Natural symptom fluctuation that can look like improvement or worsening in studies.
Rehabilitation: Therapy focused on restoring function and safety.
Reimbursement: Payment by an insurer or plan for healthcare services.
Relapse: Returning to substance use after a period of reduction or abstinence.
Release of information (ROI): The signed permission allowing medical records to be shared.
Remote monitoring: Checking device or symptom data at a distance, when supported by a system.
Remote programming: Programming done with telemedicine support, when available and approved.
Renewal (benefits): Continuation of benefits after a review period.
Responder: A person who meets a defined improvement threshold.
Response inhibition: The ability to stop an impulse before acting.
Response rate: The percentage of people who meet improvement criteria in a study.
Rest tremor: Tremor that appears when the body part is relaxed and supported.
Restlessness: A drive to move, common during cluster headache attacks and some anxiety states.
Restraint: A safety intervention that limits movement to prevent immediate harm.
Residual limb pain: Pain felt in the remaining limb tissue after amputation.
Resilience: The ability to adapt and recover during ongoing stressors.
Resource list: A list of contacts and supports to use during transitions or crises.
Return to work plan: A stepwise plan to resume work safely after medical changes.
Reversible: DBS can be turned off, and settings can be changed.
Review of systems: A structured symptom review done during medical visits.
Reward pathway: Brain circuits involved in motivation and reinforcement.
Risk-benefit balance: Weighing potential benefits against potential harms when deciding on a treatment.
Risk factor: A feature that increases the chance of an outcome or complication.
RLS (restless legs syndrome): A condition with uncomfortable leg sensations and urge to move, often worse at night.
Role clarity: Clear agreement on who does what in caregiving or teamwork.
Rotation (symptom): Turning or twisting movements, often discussed in dystonia.
Routine follow-up: Planned visits to check symptoms, device function, and long-term maintenance.
RRT (recommended replacement time): A manufacturer term indicating the device should be replaced soon.
RTW (return to work): The process of resuming work after illness or surgery.
Rubral tremor: A tremor pattern often linked to injury near the red nucleus.

S-ICD: A subcutaneous implantable cardioverter-defibrillator, relevant when coordinating device safety planning.
Safety checklist: A list of key steps to reduce risks in care or daily living.
Safety plan: A written plan for what to do if risk rises, such as worsening self-harm urges.
Salvage therapy: A treatment used after standard options have failed.
Sample size: The number of participants in a study.
Screening: An early assessment used to decide if more testing is needed.
Screening tool: A brief questionnaire used to identify risk or symptom severity.
Secondary gain: Benefits that can unintentionally reinforce symptoms, such as avoiding stressors.
Secondary movement disorder: Abnormal movements caused by a known brain injury or lesion.
Secondary parkinsonism: Parkinson-like symptoms caused by another condition.
Sedation: Medication used to reduce awareness or anxiety, sometimes used in procedures.
Segmented contact: A split contact design that allows more precise stimulation shaping.
Selective serotonin reuptake inhibitor (SSRI): A medication class used for depression, anxiety, and OCD.
Self-efficacy: Confidence in your ability to manage symptoms and follow care routines.
Self-harm: Intentional injury to oneself, often linked to distress and requiring careful safety planning.
Self-injurious behavior: Behaviors that cause self-harm, sometimes seen in severe behavioral conditions.
Sensitization: When the nervous system becomes more reactive over time.
Sensory pathway: Nerve routes that carry touch and pain information to the brain.
Shared decision-making: A process where clinicians and patients choose a plan together.
Sham condition: A control condition meant to mimic treatment without active stimulation.
Sham-controlled trial: A study that compares active stimulation with a simulated condition to test true treatment effects.
Side effect: An unwanted effect from a medication, procedure, or stimulation.
Signal artifact: A false signal or distortion in imaging or recordings.
Sleep apnea: Repeated breathing pauses during sleep, relevant to fatigue and anesthesia planning.
Sleep disruption: Trouble falling asleep or staying asleep due to symptoms or stress.
Social support: Practical and emotional help from other people.
Somatosensory pathway: Nerve routes carrying touch and pain information from body or face to the brain.
Spasticity: Increased muscle tone and stiffness due to nervous system injury.
Speech change: Changes in speech clarity or volume, sometimes related to stimulation or disease.
Spillover effect: When stimulation affects nearby circuits and causes side effects.
Spinal cord stimulation (SCS): Implanted stimulation near the spinal cord to change pain signaling.
Stigma: Shame or social judgment tied to illness or treatment.
Stimulator: Another term sometimes used for the IPG or DBS system.
Stimulation: Electrical pulses delivered by DBS to change circuit activity.
Stimulation field: The area influenced by stimulation settings and contact choice.
Stimulation-related side effect: An unwanted effect from stimulation that may improve with programming changes.
Stress response: The body’s alarm system that can worsen symptoms and coping.
Stroke: Brain injury from interrupted blood flow or bleeding.
Subcallosal cingulate (SCC): A mood-network region studied as a DBS target in treatment-resistant depression.
Substance use disorder (SUD): A chronic condition involving continued substance use despite harm.
Support person: A trusted person who helps with appointments, observation of changes, and practical device routines.
Symptom diary: A simple record of symptoms, triggers, sleep, and treatments.
Symptom drift: Gradual change in symptom control over time.
Systematic review: A structured summary of available studies, aiming to reduce bias.
Tardive dyskinesia: Involuntary movements often linked to long-term dopamine-blocking medications.
Target: The specific brain region chosen for DBS lead placement.
Task-specific tremor: Tremor that shows up mainly during a specific task.
Telemetry: Device communication that allows reading and adjusting settings.
Telemedicine: Care delivered by video or phone when appropriate.
TENS: Transcutaneous electrical nerve stimulation, a surface stimulation tool often discussed in safety contexts.
Therapeutic window: The range between helpful settings and settings that cause side effects.
Thalamus: A deep brain relay station involved in movement and sensation.
Thalamotomy: A lesioning procedure in the thalamus aimed at reducing tremor.
Tic: A sudden repeated movement or sound, often preceded by an urge.
Tolerance: When the body adapts so a treatment feels less effective over time.
Tourette’s syndrome: A condition with motor and vocal tics starting in childhood.
Trajectory: The planned path of the DBS lead through the brain.
Transition of care: Changing providers, clinics, or insurance while maintaining continuity.
Treatment-resistant (TR): Symptoms remain severe despite appropriate trials of evidence-based treatments.
Treatment-resistant depression (TRD): Major depression that does not improve enough after multiple treatment attempts.
Trigger: A factor that reliably increases symptoms.
Trigeminal neuralgia: Facial pain with brief, shock-like bursts, often triggered by light touch.
Trigeminal neuropathic pain: Ongoing facial nerve pain caused by trigeminal nerve injury or dysfunction.
Tremor: An involuntary, rhythmic shaking movement.
Tremor network: Connected brain pathways that can lock into a rhythm and produce shaking.
Trial period: A time-limited test of a plan, accommodation, or therapy to evaluate effect.
Tuning: Adjusting stimulation settings to balance benefit and side effects.
Turn off: Switching stimulation off, within clinician guidance.
Turn on: Switching stimulation on, within clinician guidance.

U-BOCS: A scale used to measure OCD severity and track change.
Ultrasound: Imaging using sound waves, generally different from MRI concerns.
Unilateral: On one side of the body or brain.
Unit dose: A single measured dose of a medication.
Unpredictable off: Off periods that do not follow a reliable schedule.
Urgency (urination): A sudden strong need to urinate, sometimes seen in neurologic conditions.
Urinary retention: Difficulty emptying the bladder, sometimes a medication side effect.
USPS mail delay: Delivery delays that can affect medication or equipment shipments.
Vagus nerve stimulation (VNS): A neuromodulation therapy that stimulates the vagus nerve.
Vascular parkinsonism: Parkinson-like symptoms linked to strokes affecting movement circuits.
Ventral capsule: A fiber pathway region connecting deep structures to frontal brain areas.
Ventral intermediate nucleus (VIM): A thalamus target commonly used in DBS for tremor.
Ventral striatum: A reward and habit-related region connected to motivation and impulse control.
Verapamil: A common first-line preventive medication for cluster headache.
Vestibular: Related to balance and inner ear systems.
Video visit: A telemedicine appointment.
Virtual care: Care delivered through telemedicine platforms.
Visual hallucination: Seeing things that are not there, sometimes linked to Parkinson’s disease or medications.
VMAT2 inhibitor: A medication class used to reduce tardive dyskinesia movements.
Voice change: Changes in loudness or clarity, sometimes related to stimulation or disease.

Wearing off: When each medication dose helps for a shorter time than it used to.
Wellness plan: A personal plan for sleep, movement, nutrition, stress, and follow-up.
Wound care: Steps to keep a surgical wound clean and healing properly.
Wound drainage: Fluid leaking from the incision.
Wound healing: The body’s repair process after surgery.
Written instructions: Clinic-provided steps for medication timing and appointment preparation.
Written priorities: A list of tasks in writing.

X-ray: Ionizing radiation used for medical imaging or for scanning bags.

Y-BOCS: A standardized scale used to measure OCD severity and track change.
Yellow flags: Early warning signs that strain is building and the plan should be adjusted before burnout worsens.
YGTSS: A standardized scale used to measure tic severity and impairment.

Z-drugs: A group of prescription insomnia medicines.
Zona incerta: A deep brain area near tremor pathways sometimes used in tremor DBS approaches.