What is deep brain stimulation therapy?

Deep brain stimulation (DBS) is a neurosurgical procedure that places electrodes into the brain. The electrodes are connected to an implanted battery that sends electrical signals to the brain. These electrical impulses block abnormally firing neurons in the brain. DBS has helped restore function in people with movement disorders such as dystonia and essential tremor. DBS regulates muscle tone, improves function and prevents progression of the movement disorder.

Deep brain stimulation (DBS) is a surgical procedure for treating a variety of disabling neurological symptoms—most commonly the debilitating symptoms of Parkinson's disease (PD), such as tremor, rigidity, stiffness, slowed movement and walking problems. The procedure is also used to treat essential tremor, a common neurological movement disorder. At present, the procedure is used only for patients whose symptoms cannot be adequately controlled with medications.

DBS uses a surgically implanted, battery-operated, medical device called a neurostimulator—similar to a heart pacemaker and approximately the size of a stopwatch—to deliver electrical stimulation to targeted areas in the brain that control movement, blocking the abnormal nerve signals that cause tremor and PD symptoms.

Before the procedure, a neurosurgeon uses magnetic resonance imaging (MRI) or computed tomography (CT) scanning to identify and locate the exact target within the brain where electrical nerve signals generate the PD symptoms. Some surgeons may use microelectrode recording—which involves a small wire that monitors the activity of nerve cells in the target area—to identify the precise brain target that will be stimulated. Generally, these targets are the thalamus, subthalamic nucleus and globus pallidus.

The DBS system consists of three components: the lead, the extension and the neurostimulator. The lead (also called an electrode)—a thin, insulated wire—is inserted through a small opening in the skull and implanted in the brain. The tip of the electrode is positioned within the targeted brain area.

The extension is an insulated wire passed under the skin of the head, neck and shoulder, connecting the lead to the neurostimulator. The neurostimulator (the "battery pack") is the third component and is usually implanted under the skin near the collarbone. In some cases, it may be implanted lower in the chest, or under the skin over the abdomen.

Once the system is in place, electrical impulses are sent from the neurostimulator, up along the extension wire and the lead and into the brain. These impulses interfere with and block the electrical signals that cause PD symptoms.

This information is based on source information from the National Institute of Neurological Disorders and Stroke.

This therapy employs a small electrode, implanted into a specific area of your brain, where the electrode delivers short electrical pulses. The pulses alter the patterns of activity in your brain that are responsible for your disease symptoms.

Treatments with deep brain stimulation were done for several years on an experimental basis, and because positive treatment results were observed, the Food and Drug Administration approved use of deep brain stimulation (DBS) to treat conditions such as Parkinson's disease in 2002. The use of DBS remains a standard treatment for Parkinson's and several brain disorders that are similar to Parkinson's.

Progress in the development of implantable DBS devices advanced quickly, thanks to a similar existing technology: heart pacemakers. In fact, the design of the devices is so similar that DBS devices are often described as brain pacemakers.

Deep brain stimulation (DBS) is a surgical procedure used to treat a variety of neurological disorders, including movement disorders such as dystonia. A battery-powered stimulator—essentially a brain pacemaker—is surgically implanted and delivers electrical stimulation to the areas of the brain associated with dystonia. The stimulator is implanted into the chest or abdomen. Extension wires connect the stimulator to leads deep in the brain. The stimulation is adjusted by remote control to achieve the best settings for you.

The phases of DBS are:

  • pre-surgical assessment and work-up
  • implanting the leads
  • implanting the stimulator
  • activating the stimulator
  • programming the stimulation settings

After you are determined to be a candidate and cleared for surgery, hardware is surgically implanted in the brain and body. Adults are typically awake during the lead implantation process and participate in the placement by responding to questions and instructions from the surgical team. The stimulators and wires are implanted under general anesthesia.

After a brief period of healing, the stimulator settings are activated and adjusted over a series of appointments. It can take weeks or months for you to achieve full benefit. The stimulators must be replaced every now and then with outpatient surgery. Additional programming adjustments may be needed.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.