What is Deep Brain Stimulation (DBS)?
Deep Brain Stimulation (DBS) is a medical treatment involving the implantation of a device that sends electrical impulses to specific areas of the brain. This therapy is primarily used for treating neurological disorders, especially when medications are ineffective. The procedure involves the placement of electrodes within the brain, which are connected to a small, implanted device known as a pulse generator, commonly referred to as a "brain pacemaker." The electrical impulses delivered by the DBS system help regulate abnormal brain activity, offering relief for conditions such as Parkinson's disease, tremors, and other movement disorders.
DBS has gained significant attention for its ability to manage symptoms when traditional treatments fail. As a minimally invasive surgery, it offers a potential solution for many patients who have not found relief through medication alone.
How Does Deep Brain Stimulation Work?
Deep Brain Stimulation works by modifying the electrical activity in specific areas of the brain that are responsible for controlling movement and other functions. The implanted electrodes emit controlled electrical pulses that help to restore the balance of brain activity. This treatment is particularly effective in reducing symptoms of movement disorders, such as tremors, rigidity, and bradykinesia (slowness of movement), which are common in conditions like Parkinson's disease.
Deep Brain Stimulation helps control symptoms and improve quality of life by "interrupting" the faulty brain signals that cause the abnormal movements. The pulse generator that is implanted under the skin in the chest area can be adjusted externally to fine-tune the brain stimulation, allowing doctors to modify the treatment based on the patient's response.
What Medical Conditions Can DBS Treat?
Deep Brain Stimulation (DBS) is a versatile treatment primarily used for neurological and psychiatric conditions that affect movement and brain function. It involves the implantation of electrodes in specific brain areas to regulate abnormal electrical activity. While DBS is most commonly associated with movement disorders, ongoing research is expanding its potential applications.
In some cases, DBS can also improve symptoms of depression and Tourette's syndrome, although its use for these conditions is more specialized. Here’s an overview of the medical conditions that DBS can treat:
DBS improves motor symptoms, reduces tremors, and decreases the need for high-dose Parkinson’s medications, which can cause side effects.
DBS can significantly reduce tremors, especially in cases where medications are ineffective.
DBS can relieve muscle spasms, reduce pain, and improve posture and movement control.
Obsessive-Compulsive Disorder (OCD)
For severe, treatment-resistant OCD, DBS can reduce symptoms when other therapies like medications and cognitive-behavioral therapy (CBT) are ineffective.
Parkinson’s Disease Dementia (PDD) and Alzheimer’s Disease
While still experimental, DBS is being studied to improve cognitive symptoms, particularly in the early stages of Alzheimer’s disease.
Major Depressive Disorder (MDD)
In cases of severe, treatment-resistant depression, DBS may help regulate brain circuits involved in mood control.
DBS can reduce the frequency and severity of tics, especially in patients who don’t respond to other treatments.
Though not a standard treatment, DBS is being investigated as a potential therapy for drug-resistant epilepsy to reduce seizure frequency.
Cluster Headaches and Chronic Pain
Experimental studies suggest that DBS may help alleviate chronic pain and cluster headaches by modulating brain regions involved in pain perception.
Inflammatory and Autoimmune Disorders (Experimental)
The goal is to modulate immune responses and reduce neurological symptoms, though this is still in the research phase.
Who Should Undergo Deep Brain Stimulation Treatment?
Candidates for DBS are usually between the ages of 30 and 80, but there can be exceptions based on individual health conditions. DBS is typically considered for individuals who:
Have a diagnosis of Parkinson's disease, essential tremor, dystonia, or other qualifying conditions.
Have not responded well to medications or are experiencing significant side effects from medications.
Are in relatively good overall health and do not have other medical conditions that may complicate surgery.
Are experiencing a decline in quality of life due to motor symptoms or other associated conditions.
How to Prepare for the Deep Brain Stimulation (DBS) Procedure?
Before undergoing DBS surgery, patients undergo a comprehensive medical evaluation, patient education, and preoperative planning. It is important to discuss the entire procedure with your neurosurgeon to understand the risks, benefits, and expected outcomes. Here’s a comprehensive guide to help you prepare:
Comprehensive Medical Evaluation
Before undergoing DBS, the doctor will recommend a detailed assessment to determine if you’re a suitable candidate. This includes:
A neurologist will evaluate your symptoms, motor function, and disease progression to confirm that DBS is appropriate for your condition.
MRI or CT scans of your brain will be conducted to identify the target areas for electrode placement.
To rule out any underlying health conditions that could affect surgery or recovery.
A mental health professional will assess your cognitive function, emotional well-being, and ability to cope with the surgery and its outcomes.
Inform your doctor about all medications you’re taking, including over-the-counter drugs, supplements, and herbal products.
You may need to stop certain medications before the procedure, especially those that affect blood clotting, like aspirin or anticoagulants.
If you have Parkinson’s disease, your doctor may adjust your medication schedule to optimize symptom control during the surgery.
Preoperative Instructions
Preoperative instructions include fasting and adjusting medications (particularly those affecting brain function or blood clotting).
You’ll likely be instructed to fast for at least 6-8 hours before the surgery to reduce the risk of complications during anesthesia.
Take a shower with an antibacterial soap on the day of the surgery to minimize the risk of infection.
Wear loose, comfortable clothes and avoid wearing jewelry, makeup, or lotions.
Emotional and Psychological Preparation
It is important to discuss the potential risks and benefits to make an informed decision. Apart from that, arrange for someone to drive you to and from the hospital, as you won’t be able to drive after the procedure.
Understand that DBS is not a cure but a treatment to manage symptoms. Discuss potential risks, benefits, and the recovery process with your doctor.
Having family or friends who can support you emotionally and physically after the surgery is vital.
What Happens During Deep Brain Stimulation (DBS)?
DBS surgery is usually performed under local anesthesia, meaning the patient will be awake, but the area will be numb. It helps the patient remain sedated and relaxed. The entire procedure usually takes between 4-6 hours depending on several factors like the surgical expertise of the doctor, severity of the medical condition, etc, and requires hospitalization for a few days to monitor recovery. Here is what you can expect during the Deep Brain Stimulation (DBS) surgery:
Small electrodes are surgically implanted into specific regions of the brain using a minimally invasive technique. These electrodes are placed with the help of stereotactic guidance, which means the doctor leverages a CT or MRI-guided system to place the electrodes precisely in the targeted brain areas..
Pulse Generator Placement
After the electrodes are in place, a pulse generator (similar to a pacemaker) is implanted under the skin in the chest or abdomen. This device is responsible for sending electrical impulses to the brain through the electrodes. The lead wires connecting the electrodes to the pulse generator are tunneled under the skin.
What Happens After Deep Brain Stimulation (DBS)?
Post-surgery, patients are typically monitored for several days in the hospital. The stimulation device is not activated immediately. Doctors wait until the wound has healed before turning on the DBS system. Once activated, adjustments are made to ensure the stimulation is effective in controlling symptoms.
Recovery After DBS Procedure
Recovering from Deep Brain Stimulation (DBS) surgery is a gradual process that involves physical, emotional, and mental adjustments. While the recovery time varies from patient to patient, most people can resume normal activities within 4-6 weeks. Patients experience significant improvements in their symptoms if they follow proper recovery tips to ensure a smooth recovery. However, the healing process involves:
Keep the surgical site clean and avoid strenuous activities.
Do not submerge the surgical site in water (e.g., no swimming or hot tubs) until your doctor gives the okay.
Redness, swelling, warmth, pus, or fever could indicate an infection and should be reported immediately.
Mild pain or discomfort around the surgical site is common. Use prescribed pain medications as directed.
Applying ice packs (wrapped in a cloth) can reduce swelling and discomfort, but avoid direct contact with the skin.
Avoid strenuous activities, heavy lifting, and vigorous exercise for at least 4–6 weeks.
Avoid bending over as it reduces the risk of pressure on the surgical site and prevents complications like bleeding.
Attending follow-up appointments to fine-tune the settings of the DBS device.
Monitoring for any potential side effects, such as mood changes or headaches.
What are the Advantages of Deep Brain Stimulation (DBS)?
Deep Brain Stimulation (DBS) offers numerous benefits, particularly for individuals suffering from movement disorders like Parkinson’s disease, essential tremor, and dystonia. While DBS is not a cure, it significantly improves the quality of life by managing symptoms that are difficult to control with medication alone. Here are the key advantages of DBS:
Improved Symptom Control
Reduced Tremors and Rigidity
DBS is highly effective in reducing tremors, stiffness, and muscle rigidity, especially in patients with Parkinson’s disease and essential tremor patients.
It helps improve coordination, balance, and fine motor skills, making daily tasks easier.
Decreased Dependence on Medications
Many patients can reduce their reliance on Parkinson’s medications, which often come with troublesome side effects like nausea, dizziness, and hallucinations.
Reducing medication intake can help minimize drug-related side effects while still maintaining symptom control.
Adjustable and Personalized Treatment
The DBS device can be adjusted externally, allowing doctors to fine-tune the electrical impulses to achieve optimal symptom relief.
If side effects occur, adjustments can be made without additional surgery.
Minimally Invasive Surgery
Compared to traditional brain surgery, DBS involves smaller incisions and less invasive procedures, leading to faster recovery.
Many DBS programming sessions can be done on an outpatient basis.
DBS has been shown to provide symptom relief for many years, with ongoing adjustments to maintain effectiveness.
As the disease progresses, DBS settings can be modified to adapt to changing symptoms.
Cognitive and Emotional Benefits
Some patients report improvements in mood and quality of life, partly due to reduced physical disability and better symptom control.
Less Depression and Anxiety
By alleviating motor symptoms, DBS can indirectly reduce the emotional burden associated with chronic illness.
Reversible and Non-Permanent
If the treatment is no longer effective or causes unacceptable side effects, the DBS system can be turned off or removed without permanent brain damage.
Many patients regain the ability to perform daily activities independently.
DBS can improve walking, posture, and overall mobility, reducing the risk of falls.
Potential for Non-Movement Disorder Applications
DBS is being explored as a treatment for conditions like obsessive-compulsive disorder (OCD), depression, and even Alzheimer's disease, showing promising results in clinical trials.
Pulse Generator Programming and Side Effects of DBS
Once the DBS device is implanted, it is programmed to send electrical pulses at optimal settings for the patient’s symptoms. However, rare side effects can occur, which are often managed by adjusting the pulse generator settings. Some common side effects include:
Mild headaches or dizziness
Tingling sensations or numbness
Temporary speech or balance changes
Mood swings or cognitive changes
Choose Artemis Hospitals for Deep Brain Stimulation (DBS) Surgery in Gurgaon
Receiving the right treatment for neurological conditions is crucial for managing symptoms and preventing complications. At Artemis Hospitals, a team of renowned neurologists, neurosurgeons, and rehabilitation specialists work together to provide comprehensive, patient-centered neurological care.
Renowned Neurologists & Neurosurgeons
The hospital has a team of highly experienced neurologists and neurosurgeons who specialise in treating complex brain, spine, and nerve disorders. Their expertise in minimally invasive and advanced neurosurgical techniques ensures precise and effective treatments.
Cutting-Edge Technology & Neurodiagnostics
Artemis Hospitals are equipped with the latest diagnostic and treatment technologies, including high-resolution MRI, CT scans, EEG, EMG, and advanced neuroimaging. These tools allow for early and accurate diagnosis, leading to more effective treatment outcomes.
Minimally Invasive & Robotic Neurosurgery
The hospital offers minimally invasive brain and spine surgeries, such as neuro-navigation-assisted procedures, endoscopic brain surgery, and robotic-assisted spinal surgery. These techniques result in faster recovery, reduced pain, and lower complication risks.
24/7 Stroke & Emergency Neurology Care
Artemis Hospitals provide round-the-clock stroke care, with rapid intervention for thrombectomy, clot-dissolving treatments, and neurocritical care support. The hospital’s dedicated stroke unit ensures immediate response and rehabilitation for stroke patients.
Multidisciplinary Approach & Rehabilitation Support
A team of neurologists, neurosurgeons, physiotherapists, speech therapists, and rehabilitation experts work together to provide comprehensive post-treatment care, ensuring maximum recovery and long-term neurological health.
The neurosurgery department at Artemis Hospital, one of the best neurosurgery hospitals in Gurgaon, offers cutting-edge surgical treatments along with non-surgical approaches aimed at restoring patients’ overall health and well-being. To book an appointment, contact us at +91-124-4511111, or schedule an online appointment through the Artemis Mobile App or our online portal, available on iOS and Android. If you prefer, feel free to contact us via WhatsApp at +91 9599285476 for any assistance with your appointment.
Reviewed By Dr. Sushant Srivastava
Chairperson - Cardio Thoracic and Vascular Surgery
Artemis Hospitals
Frequently Asked Questions
Why is DBS used?
DBS is used to alleviate symptoms of neurological disorders by sending electrical impulses to the brain.
What conditions can be treated with Deep Brain Stimulation?
Conditions like Parkinson’s disease, essential tremor, dystonia, and in some cases, OCD and Alzheimer's.
How effective is DBS for Parkinson’s disease?
DBS is highly effective in reducing motor symptoms and improving the quality of life for Parkinson’s patients.
How long does a deep brain stimulation procedure last?
The DBS surgery itself lasts about 4-6 hours. However, the OT time may vary depending on several factors, such as the surgical expertise of the surgeon, severity of the condition, etc.
What are the risks or complications of DBS?
Risks include infection, bleeding, device malfunction, and potential changes in mood or cognitive function.
Can DBS change your personality?
DBS may cause mood changes or cognitive effects, but it does not typically cause a permanent personality shift.
What does stimulation do to the brain?
It helps regulate abnormal brain activity, improving symptoms like tremors and rigidity.
Is DBS a permanent treatment?
DBS is not a cure but can offer long-term symptom relief. The device may need adjustments over time.
How often does the DBS device need adjustments?
The DBS device is adjusted during regular follow-up visits, typically every 3-6 months.
Can DBS be reversed if needed?
DBS can be turned off or the device can be removed if needed.
What lifestyle changes are recommended after DBS?
Patients should avoid certain electronic devices and heavy physical activity during the initial recovery period.
Can I use electrical and electronic devices if I have DBS devices implanted?
Caution is advised with certain devices, such as magnets and metal detectors, as they may interfere with DBS.
Does deep brain stimulation cure the diseases for which it’s used?
No, DBS helps manage symptoms but does not cure the medical condition associated with it.
