English 
Deep Brain Stimulation (DBS) Surgery
Deep Brain Stimulation (DBS), commonly referred to as “brain pacemaker surgery,” is an advanced neurosurgical treatment used to manage movement disorders such as Parkinson’s disease. Parkinson’s occurs due to a deficiency of dopamine in the brain, leading to symptoms such as tremors, muscle rigidity, slow movement (bradykinesia), and postural instability.
DBS is performed when medications such as levodopa or dopamine agonists are no longer sufficient to control symptoms or when side effects of long-term drug use become intolerable. The procedure involves implanting thin electrodes into specific regions of the brain responsible for motor control. These electrodes are connected to a small device, similar to a pacemaker, implanted under the skin in the chest. The device sends electrical impulses to regulate abnormal brain activity, reducing symptoms and enhancing the patient’s ability to perform daily tasks.
Why Is DBS Surgery Performed?
DBS is primarily performed on patients with advanced Parkinson’s disease whose symptoms cannot be adequately managed with medication alone. In addition to Parkinson’s, DBS may also be used to treat:
- Essential tremor (a neurological disorder causing involuntary shaking).
- Dystonia (involuntary muscle contractions).
- Epilepsy.
- In some cases, severe obsessive-compulsive disorder (OCD).
For Parkinson’s patients, DBS provides a significant improvement in motor symptoms, allowing them to reduce their medication dosage and experience fewer side effects. The goal is not to cure Parkinson’s, as it is a progressive neurological disease, but to control its most disabling symptoms and improve quality of life.
How Is DBS Surgery Performed?
DBS surgery is a highly precise and carefully planned procedure, usually carried out in two main stages:
Stage 1: Electrode Placement
Using advanced brain imaging techniques such as MRI and CT scans, neurosurgeons identify the exact regions of the brain responsible for motor control—often the subthalamic nucleus (STN) or the globus pallidus internus (GPi). Thin electrodes are then implanted into these areas through small openings in the skull. In some cases, patients remain awake during part of the surgery so doctors can monitor their responses and fine-tune electrode placement.
Stage 2: Implanting the Neurostimulator
After electrodes are placed, they are connected to a small battery-powered device called a neurostimulator, which is implanted under the skin of the chest. Wires running under the skin link the electrodes to the device. Once activated, the neurostimulator sends controlled electrical signals to the targeted brain regions to regulate abnormal activity.
The surgery typically takes several hours and is performed under general or local anesthesia, depending on the case. Patients usually stay in the hospital for a few days for monitoring and initial device programming.
Recovery After DBS Surgery
Recovery following DBS surgery is relatively quick compared to other neurosurgical procedures. Most patients can resume light activities within 1–2 weeks, although full adjustment may take longer as the device settings are gradually optimized.
In the weeks after surgery, neurologists and neurosurgeons work together to program and fine-tune the neurostimulator. Adjustments are made to balance symptom relief with minimal side effects. Patients usually experience gradual improvement over weeks to months as the stimulation settings are optimized.
Physical therapy, occupational therapy, and speech therapy may also be recommended to enhance recovery and improve daily function.
Risks and Considerations of DBS Surgery
Like any surgical procedure, DBS carries some risks. Potential surgical risks include infection, bleeding in the brain, or hardware-related complications such as lead dislocation. However, serious complications are rare when the surgery is performed in specialized centers by experienced neurosurgeons.
Long-term side effects may include temporary speech difficulties, balance problems, or mood changes, but these are often reversible with adjustments to the stimulation settings.
Patients should also understand that DBS does not cure Parkinson’s disease; rather, it manages symptoms. The progression of the disease continues, but with much-improved quality of life and functionality.
Advantages of DBS Surgery
DBS surgery offers numerous benefits for patients with Parkinson’s disease and other movement disorders:
- Improved motor function: Reduces tremors, rigidity, and slow movement.
- Reduced medication dependency: Allows patients to decrease dosages, minimizing side effects.
- Reversible and adjustable: Unlike permanent brain lesions, DBS settings can be adjusted or turned off if necessary.
- Long-term relief: Many patients enjoy significant symptom control for 5–10 years or more.
- Enhanced quality of life: Patients regain independence, mobility, and confidence.
These benefits make DBS a life-changing treatment for patients whose lives are severely disrupted by motor symptoms.