Deep brain stimulation (DBS) uses a device called a neurostimulator to deliver electrical signals to the areas of the brain that control movement, pain, mood, weight, and awakening.
The DBS system consists of three parts:
Surgery is done to place each part of the neurostimulator system. In adults, surgery takes place in two stages (two separate surgeries).
Stage 1 is usually done under local anesthesia, meaning you are awake, but pain-free. (In children, general anesthesia is given.)
Stage 2 is done under general anesthesia, meaning you are asleep and pain-free. The timing of this stage of surgery depends on where in the brain the stimulator will be placed.
Once connected, electrical pulses travel from the neurostimulator, along the extension wire, to the lead, and into the brain. These tiny pulses interfere with and block the electrical signals that cause symptoms of certain diseases.
DBS is commonly done for persons with Parkinson disease when the symptoms cannot be controlled by medicines. DBS does not cure Parkinson disease, but can help reduce symptoms such as:
Deep brain stimulation may also be used to treat the following conditions:
DBS is considered safe and effective when done in the right patients.
Risks associated with deep brain stimulation placement may include:
Problems may also occur if parts of the DBS system break or move. This may include:
Possible risks of any brain surgery are:
Risks of general anesthesia are:
You will have a complete physical exam.
Your doctor will order many laboratory and imaging tests, including a CT or MRI scan. These imaging tests are done to help the surgeon pinpoint the exact part of the brain responsible for the symptoms. The images are used to help the surgeon place the lead in the brain during surgery.
You might have to see more than one specialist, such as a neurologist, neurosurgeon, or psychologist, to make sure that the procedure is right for you and has the best chance of success.
Before surgery, tell your doctor or nurse:
During the days before the surgery:
The night before and on the day of surgery, follow instructions about:
You may need to stay in the hospital for about 3 days.
The doctor may prescribe antibiotics to prevent infection.
You will return to your doctor's office at a later date after surgery. During this visit, the stimulator is turned on and the amount of stimulation is adjusted. Surgery is not needed. This is process is also called programming.
Call your doctor if you develop any of the following after DBS surgery:
People who have DBS usually do well during the surgery. Many persons have great improvement in their symptoms and quality of life, though most still need to take medicine at lower dosages.
This surgery, and surgery in general, is riskier in people over age 70 and those with health conditions such as high blood pressure and diseases that affect blood vessels in the brain. You and your doctor should carefully weigh the benefits of this surgery against the risks.
The DBS procedure can be reversed, if needed.
Globus pallidus deep brain stimulation; Subthalamic deep brain stimulation; Thalamic deep brain stimulation; DBS; Brain neurostimulation
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National Institute of Neurological Disorders and Stroke. Deep Brain Stimulation for Parkinson's Disease Information Page. Last updated February 7, 2012. Available at: http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm. Accessed February 14, 2013.
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Updated by: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles CA; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Surgery at Cheyenne Regional Medical Center, Cheyenne WY; Department of Anatomy at UCSF, San Francisco CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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