How is deep brain stimulation performed?

Dr. Nader Pouratian, MD

Deep brain stimulation (DBS) surgery is usually done in two stages:

  • The first stage is when the neurosurgeon precisely implants electrodes deep within your brain. To do this, a frame is placed on your head, a computed tomography (CT) scan is obtained and then the electrodes are carefully implanted in your brain. The doctors monitor you throughout the surgery.
  • The second stage is about two weeks later, when the generator is implanted into the chest.

After these two surgeries, it takes about three to six months of programming to customize the electrical stimulation to your brain.

Deep brain stimulation is performed in two stages. During the first stage, a neurosurgeon inserts an electrode into a targeted area of the brain. Both frame-based and newer frameless techniques for placing the implants can be used.

During the second stage, the electrode is connected to an implantable pulse generator (IPG), which is placed beneath the skin of the chest wall, like a heart pace-maker.

During deep brain stimulation the person is awake. The person undergoes a preoperative magnetic resonance imaging (MRI) scan that uses a program like GPS to map out the brain. This is how the surgeon knows where to place electrodes. Depending how many electrodes are placed small incisions are made into the head while the person is asleep. Electrodes are placed into the targeted areas. The person then wakes up while in the operating room for neurological testing to confirm placement of the electrodes. The person is then placed back asleep and two small implanted batteries are placed. This surgery can make significant improvements to a person’s life.

Deep brain stimulation surgery is performed with a frameless technique, creating multiple stages of surgery. Watch Gareth Davies, MD, of Portsmouth Regional Hospital, explain more.

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