What is deep brain stimulation?
Deep brain stimulation (DBS) is a surgical procedure that involves implanting electrodes in the brain, which deliver electrical impulses that block or change the abnormal activity that cause symptoms.
The deep brain stimulation system consists of four parts:
- Leads (thin insulated wires) that end in electrodes that are implanted in the brain
- A small pacemaker-like device, called a pulse generator, that creates the electrical pulses
- Extension leads that carry electrical pulses from the device and are attached to the leads implanted in the brain
- Hand-held programmer device that adjusts the device’s signals and can turn the device off and on.
In deep brain stimulation, electrodes are placed in the targeted areas of the brain. The electrodes are connected by wires to a type of pacemaker device (called an implantable pulse generator) placed under the skin of the chest below the collarbone.
Once activated, the pulse generator sends continuous electrical pulses to the target areas in the brain, modifying the abnormal activity in that area of the brain that is causing symptoms. The deep brain stimulation system operates much the same way as a pacemaker for the heart. In fact, deep brain stimulation is referred to as “the pacemaker for the brain.”
What kinds of neurologic conditions can be treated with deep brain stimulation?
Deep brain stimulation is approved by the Food and Drug Administration to treat a variety of movement and neurologic disorders including:
Deep brain stimulation is also being studied for use in the following conditions:
- Multiple sclerosis
- Chronic pain
- Traumatic brain injury
- Tourette syndrome
- Stroke recovery
- Thalamic pain syndrome
- Alzheimer’s disease
- Anorexia nervosa
Who is a candidate for deep brain stimulation surgery?
Before being considered a candidate for deep brain stimulation (DBS), patients must undergo an extensive evaluation process. Ideally, a multidisciplinary team of specialists including a neurologist, neurosurgeon, neuropsychologist and psychiatrist will assess the patient.
If patients are well managed on medications, DBS is not considered. Candidates for DBS are generally patients who meet these criteria:
- Symptoms are not well controlled despite receiving the appropriate dose of medications.
- Symptoms are significantly reducing a patient’s quality of life.
- Side effects from current medications cannot be tolerated.