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What is Deep Brain Stimulation (DBS)?

DBS is a neurosurgical procedure that involves implanting electrodes in specific brain areas to initiate electronic brain stimulation.

deep brain stimulation

Article Contents

Components of DBS

DBS is a neurosurgical procedure that involves implanting electrodes in specific brain areas to initiate electronic brain stimulation to facilitate the treatment and management of various medical disorders.1 The device used in DBS is known as a DBS stimulator.


Although a well-established treatment, deep brain stimulation surgery is usually reserved for those whose symptoms are not controlled by drugs.1 Deep brain stimulators (sometimes called mind stimulators or brain pacemakers) are battery-powered devices composed of three parts:

  • DBS Lead: Each lead comprises four electrodes on the end of a thin, insulated coiled wire. The electrodes’ position is placed in the brain depending on the treated condition.
  • Neurostimulator: The neurostimulator, also known as implantable pulse generator (IPG), is implanted under the skin, close to the collarbone.2 It can also be implanted in the lower portion of the chest or under the skin of the abdomen. The IPG is powered by a battery that is the source of the electrical signals sent to the brain. The battery is expected to last three to five years. However, the battery cannot be replaced in isolation. As such, when the battery needs to be replaced, the entire neurostimulator is replaced; this replacement accounts for the deep brain stimulation cost.
  • Extension: The extension is a thin, insulated wire that links a lead to a neurostimulator.3 It is passed under the skin.

How Deep Brain Stimulation Therapy Works

DBS involves using an implanted neurostimulator that is identical to a cardiac pacemaker. When turned on, the neurostimulator sends a steady stream of high-frequency electrical signals for electrical stimulation of the brain portion linked to the disorder being treated.

The process requires only a few hours of hospital stay, but the recovery could take several weeks.

Deep Brain Stimulation Surgery and Implantation Procedure

The deep brain stimulation surgery procedures are divided into two stages:

  • Stage one: The first stages of DBS involve implanting electrodes into the brain. Stage one is usually done under local anesthesia for adults. Children are placed under general anesthesia. The entire process lasts about five to seven hours.4
  • Stage two: Stage two of the surgery involves implanting of the neurostimulator close to the collarbone (can also be implanted in the lower chest or abdomen area), the tunneling of the extension wire under the skin of the head, neck, and shoulder, and the connection of the extension to the neurostimulator. Once connected, the deep brain stimulator becomes active and facilitates electrical stimulation of the brain.5

Conditions that Are Treated Using DBS

As earlier stated, DBS is an established neurosurgical procedure that has shown remarkable success in treating and managing several disease conditions, especially in disease conditions affecting motor movement.

Essential Tremor

Deep brain stimulators have been employed to improve involuntary movement conditions linked to essential tremors. Essential tremor is often accompanied by involuntary body parts (arms, head, and hands).

Obsessive-Compulsive Disorder

DBS is an effective treatment option for refractory obsessive-compulsive disorder (OCD).6 Deep brain stimulation procedure has proven to be a very successful treatment option in managing OCD that has previously shown resistance to treatment with drugs.

Multiple Sclerosis

DBS is an alternate option to control tremors induced by multiple sclerosis, which are unresponsive or show low response to medications.7

Dystonia

Brain stimulation therapy has been shown to reduce symptoms’ acuteness and the degree of disability in people with dystonia. In addition, DBS may reduce involuntary muscle contractions that result in symptoms like poor posture, repetitive movements, and torsion.

Parkinson's Disease

DBS is used in alleviating deep brain stimulation Parkinson’s motor impairment symptoms. These symptoms include tremors, rigidity, and stiffness. Other deep brain stimulation Parkinson’s symptoms are gait disturbance and dyskinesias.

It should be noted that although DBS is employed for people whose symptoms are not properly controlled by medication, only individuals who show some level of improvement due to drug users will benefit from DBS.

Risks and Potential Side-Effects

brain stimulation
As can be observed with all treatment options, the deep brain stimulation surgery procedure is also accompanied by risks and side effects. These risks could be associated with the deep brain stimulator placement and movement or even breakage of the DBS system.

Side effects of deep brain stimulation procedures range from relatively mild complications like headaches and temporary tingling to more serious ones like breathing problems, balance problems, and stroke.

Stereotactic DBS vs. Interventional Image-Guided DBS

Identifying the parts of the brain responsible for the disease to be treated and the subsequent placement of the electrodes (for accuracy) relies on highly sophisticated medical equipment.

Currently, there are two DBS surgery methods used. However, there have been different arguments as to the safety of these two methods and the accuracy they lend to electrode placement. They are stereotactic DBS and interventional image-guided DBS.

Stereotactic DBS

The stereotactic DBS, the conventional method employed in electronic brain stimulation therapy, involves fitting a special headframe (known as a stereotactic headframe) on the patient’s head. This special headframe has two functions.

First, it ensures the patient’s head is immobilized during the procedure, and it also provides coordinates to help surgeons guide the electrodes to the correct location in the brain.

Interventional Image-Guided DBS

On the other hand, the interventional image-guided DBS leverages neurological imaging technologies like MRI or CT to identify where electrodes should be placed during brain stimulation surgery.8 However, interventional image-guided DBS may increase deep brain stimulation cost than stereotactic DBS.

There are advanced centers that offer both DBS neurology options, and in such cases, either option could be employed depending on several patient-related and clinical factors.8

Precautions After Deep Brain Stimulation

If you have previously undergone BDS surgery, there are several precautions you should pay attention to for safety reasons. You should always carry documentation showing that you have a DBS neurostimulator implanted. Wearing a medical identification bracelet signifying a DBS implant is also an option.8

Before going through the airport scanners or undergoing screening by airport security, you should inform the security screeners you have a neurostimulator implanted in you. While many airport detectors are safe for pacemakers, the neurostimulator’s little quantity of metal may cause the alert to go off; this is one of the many side effects of DBS stimulation.

In addition, in situations involving screening with hand-held detector devices, patients should politely inform the screeners that the detector wand should not be held over the neurostimulator for more than a few seconds to prevent interference with the neurostimulator’s functioning by the magnets in the hand-held scanners.8

Patients with a DBS implant should always consult their doctors before any MRI or surgical procedure to ensure the procedure is safe for them. In any physical therapy, patients should avoid utilizing heat to treat muscles.

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