Why is deep brain stimulation (DBS) the surgical procedure of choice for Parkinson disease (PD)?

Updated: Jan 24, 2019
  • Author: Robert A Hauser, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Deep brain stimulation (DBS) has become the surgical procedure of choice for Parkinson disease for the following reasons:

  • It does not involve destruction of brain tissue

  • It is reversible

  • It can be adjusted as the disease progresses or adverse events occur

  • Bilateral procedures can be performed without a significant increase in adverse events

Deep brain stimulation, a form of stereotactic surgery, has made a resurgence in the treatment of Parkinson disease largely because long-term complications of levodopa therapy result in significant disability over time. A better understanding of basal ganglia physiology and circuitry and improvements in surgical techniques, neuroimaging, and electrophysiologic recording have allowed surgical procedures to be performed more accurately and with lower morbidity.

Surgery for movement disorders previously involved predominantly destructive lesioning of abnormally hyperactive deep brain nuclei; however, the observation that high-frequency electrostimulation in the ventral lateral nucleus (VL) of the thalamus eliminates tremors in patients undergoing thalamotomy led to investigation of long-term DBS as a reversible alternative to lesioning procedures.


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