Deep brain stimulation (DBS) uses a device called a neurostimulator to deliver electrical signals to the areas of the brain that control movement, pain, mood, weight, and awakening.
Globus pallidus deep brain stimulation; Subthalamic deep brain stimulation; Thalamic deep brain stimulation; DBS; Brain neurostimulation
The DBS system consists of three parts:
- One or more, insulated wires called leads, or electrode that are placed into the brain
- The neurostimulator, which puts out the electric current. The stimulator is similar to a heart pacemaker. It is usually placed under the skin near the collarbone, but may be placed elsewhere in the body
- In some people another thin, insulated wire called an extension is added to connect the lead to the neurostimulator.
Surgery is done to place each part of the neurostimulator system. In adults, the whole system can be placed in 1 or 2 stages (2 separate surgeries).
Stage 1 is usually done under local anesthesia, meaning you are awake, but pain-free. (In children, general anesthesia is given.)
- Your head is placed in a special frame using small screws to keep it still during the procedure. Numbing medicine is applied where the screws contact the scalp. Sometimes, the procedure is done in the MRI machine and a frame is on top of your head rather than around your head.
- Numbing medicine is applied to your scalp at the site where the surgeon drills a small opening in the skull and places the lead into a specific area of the brain.
- If both sides of your brain are being treated, the surgeon makes an opening on each side of the skull, and two leads are inserted.
- Electrical impulses may need to be sent through the lead to make sure it is connected to the area of the brain responsible for your symptoms.
Stage 2 is done under general anesthesia, meaning you are asleep and pain-free. The timing of this stage of surgery depends on where in the brain the stimulator will be placed.
- The surgeon makes a small opening (incision), usually just below the collarbone and implants the neurostimulator. (Sometimes it is placed under the skin in the lower chest or belly area.)
- The extension wire is tunneled under the skin of the head, neck, and shoulder and connected to the neurostimulator.
- The incision is closed. The device and wires cannot be seen outside the body.
Once connected, electric pulses travel from the neurostimulator, along the extension wire, to the lead, and into the brain. These tiny pulses interfere with and block the electrical signals that cause symptoms of certain diseases.