Deep Brain Stimulation (DBS)
Deep brain stimulation is an adjustable neuromodulation method that delivers controlled electrical stimulation through electrodes placed in deep brain nuclei. It is used to control the symptoms of selected movement disorders, primarily Parkinson's disease, essential tremor and dystonia.
Última actualización: 2026-06-08
Definition
Deep brain stimulation (DBS) involves placing thin electrodes into targeted deep brain nuclei and connecting them through subcutaneous leads to a battery-powered neurostimulator (generator) implanted under the chest wall. The generator sends continuous or programmed electrical pulses to the nucleus. This stimulation modulates the abnormal activity of the relevant neural networks and eases symptoms. The system is reversible and adjustable and does not eliminate medical therapy or, if needed, future treatments.
Indications
DBS is most often used in advanced Parkinson's disease, where the response to medication fluctuates or drug-induced dyskinesias appear. It is also used in medication-refractory essential tremor and selected cases of dystonia. In some centers it is applied under specific indications for refractory obsessive-compulsive disorder and epilepsy. Candidate selection is made by a multidisciplinary team, taking into account diagnostic certainty, the likelihood that symptoms will respond to stimulation, cognitive status and general health.
Method
The procedure is usually performed with a stereotactic technique based on a map created from advanced imaging (MRI/CT). The target nucleus is chosen according to the disease; for example, the subthalamic nucleus or globus pallidus internus in Parkinson's disease, and the ventral intermediate nucleus of the thalamus in essential tremor are common targets. Correct electrode placement may be confirmed with microelectrode recording and, in some cases, test stimulation while the patient is awake. Connecting leads and the generator are then placed, and the device is programmed gradually over weeks.
Advantages and Limitations
Unlike lesioning operations that permanently destroy brain tissue, DBS is adjustable and reversible; stimulation parameters can be changed over time to reduce side effects and increase benefit. However, DBS does not cure the disease; it aims to control symptoms, and the response varies from symptom to symptom. It requires surgery, regular follow-up and battery replacement (or use of a rechargeable battery). Not every patient is a suitable candidate.
Recovery and Risks
Patients are usually monitored for a short period after surgery; device programming is carried out in the outpatient clinic over weeks. Potential risks include surgery-related bleeding or stroke, infection, hardware problems (lead fracture, migration) and stimulation-related transient side effects (changes in speech, balance or mood). No outcome is guaranteed; decisions are individualized.
Referencias
- Greenberg MS. Greenberg's Handbook of Neurosurgery. 10th ed. Thieme; 2023:1839-1844.
- Deuschl G, et al. A randomized trial of deep-brain stimulation for Parkinson's disease. N Engl J Med. 2006.
- Okun MS. Deep-Brain Stimulation for Parkinson's Disease. N Engl J Med. 2012.
Este artículo es informativo y no sustituye un examen médico. Las decisiones de diagnóstico y tratamiento son individuales.