Thursday, November 20, 2008

Deep Brain Stimulation

This is a topic near and dear to my heart. DBS surgery is essentially what drew my interest to neurosurgery in the first place, years ago. It’s not exactly a new technique. In fact, it’s been FDA-approved in the US for nearly a decade.

In DBS, a small wire about a millimeter thick (the “lead” or “electrode”) with four different possible stimulation points (the “contacts”) is placed in a very specific spot in the brain. How that spot is determined are for another post on another day, and varies somewhat from situation to situation. Usually the process involves some form of stereotactic targeting and physiologic confirmation. The implanted wire is then pulled under the skin (“tunneled”) to a place where a pacemaker-like device (the “implantable pulse generator” or IPC, also often informally called the “battery”) is implanted, most commonly just under the collar bone (“subclavicular”).

DBS has wide-ranging applications, and is FDA-approved for Parkinson’s disease and Essential Tremor.

There are numerous other movement disorders for which it has been reported to be effective, and it has been used in the past for some complex pain problems. Most recently, it has received considerable attention for certain psychiatric indications, and most experts in the field expect FDA approval for obsessive compulsive disorder (OCD) and major depression in the next several years.


  1. is there a way to tell if someone will develop Parkinsons? are there early symptoms? My grandfather had it.

  2. We know that there is a genetic contribution to the development of parkinsonian symptoms. However, only the striking minority of cases of Parkinson's Disease run in families. We have been able to learn a great deal about the disease from studying those families. You've asked several different questions here, so we'll address it in a few different posts over the holidays.

    Thanks for a good question!