What Is Deep Brain Stimulation?

Deep Brain Stimulation (DBS) is an adjunctive surgical treatment that is FDA approved for the movement disorders of Dystonia, Essential Tremor (ET) and Parkinson's Disease (PD). DBS does not replace medical therapy, but frequently allows reductions in medication and related side effects.

DBS is the surgical implantation of precisely placed stimulating leads into deep brain targets located within the basal ganglia: either the Globus Pallidus (GPi) or the subthalamic nucleus (STN). The stimulating electrodes are connected to small cables passed underneath the skin and plugged into an Internal Pulse Generator (IPG), which is also implanted underneath the skin on the upper torso.

The IPG is programmed to send a continuous stream of small, brief pulses to the tips of the stimulating leads. In PD, dopamine loss in the substantia nigra allows the STN and the GPi to disengage from normal control and become dysfunctional. In generalized DYT1 and focal dystonia, GABAergic dysfunction results in a loss of inhibiton in cortex and the basal ganglia. ET is a clinically defined syndrome with many etiologies, or underlying causes, a number of which respond to DBS. DBS modulates the basal ganglia circuit, by limiting the influence of the STN and GPi, thereby re-balancing the circuit toward more normal functioning.