Deep brain stimulation (DBS) is a functional neurosurgical procedure in which electrodes are implanted with millimetre-level precision into specific target structures deep within the brain. These electrodes are connected to a pulse generator (similar to a cardiac pacemaker) placed beneath the skin, which delivers continuous electrical stimulation that modulates abnormal neural circuit activity. I completed a fellowship in functional neurosurgery at Flinders Medical Centre and DBS is one of the central pillars of my practice at Gleneagles Fortis Hospital, Chennai.
DBS is most effective for movement disorders where specific brain circuits are dysregulated. The conditions with the strongest evidence for DBS are Parkinson's disease (where it controls tremor, rigidity, and dyskinesias), essential tremor (where stimulation of the thalamus dramatically reduces tremor), and dystonia (where it reduces abnormal sustained muscle contractions). Selected cases of obsessive-compulsive disorder also respond to DBS.
- Parkinson's disease: Patients who have good initial response to levodopa but develop motor fluctuations or dyskinesias on long-term medication are typically the best candidates
- Essential tremor: Patients with tremor that is significantly disabling and not controlled by medication
- Dystonia: Particularly generalised and cervical dystonia, especially in younger patients
Patients should not have significant cognitive impairment, active psychiatric conditions, or surgical contraindications
DBS does not cure the underlying condition, but it can produce dramatic, sustained improvement in quality of life for appropriate patients. A formal functional neurosurgery assessment determines candidacy at Gleneagles Fortis Hospital, Chennai.
Written by Dr Nigel Peter Symss, MBBS, DNB (Neurosurgery), Fellowship Paediatric Neurosurgery (Jikei University, Japan), Fellowship Spinal, Functional Neurosurgery and Microneurosurgery (Flinders Medical Centre, Australia), HOD and Senior Consultant Neurosurgeon and Functional Neurosurgeon, Gleneagles Fortis Hospital, Perumbakkam, Chennai.
