Deep Brain Stimulation or (DBS) is a surgical technique most commonly used to treat Parkinson’s disease. However, it can also be used to treat severe essential tremor and tremor or to relieve chronic pain. At present, the procedure is used only for patients whose symptoms cannot be adequately controlled with medications.

DBS is a surgical technique that involves placing a fine electrode (wire) into specific parts of the brain. The wire is then used to deliver a continuous electrical pulse to regions of the brain involved in the processing of pain signals.

The advantages of this technique are that it is reversible, nondestructive, and can be modified by adjusting stimulator settings after implantation.

Before the DBS procedure, a neurosurgeon uses magnetic resonance imaging (MRI) or computed tomography (CT) to identify and locate the exact target within the brain where electrical nerve signals are generating the symptoms of Parkinson’s Disease or source of the chronic pain.

Surgery

The DBS system, which is surgically implanted, is comprised of three parts; a lead, extension, and neurostimulator. The lead (or electrode) is a thin insulated wire that is inserted through a small opening in the skull and implanted in the area of the brain that is to be treated. The tip of the electrode is positioned within the targeted area. The extension is an insulated wire that is used to connect the lead to the neurostimulator. This is done by passing the extension under the skin of the head, neck, and shoulder.

The neurostimulator is a "battery pack” that is usually implanted under the skin near the collarbone. In some cases it may be implanted lower in the chest or under the skin over the abdomen. Once the system is in place, electrical impulses are sent from the neurostimulator to the lead. The impulses interfere with and block the electrical signals coming from that area of the brain that are causing the Parkinson’s Disease symptoms.

After the surgery is completed, an expert calibrates the unit in to ensure maximum effectiveness. The programming of the neurostimulator can take up to a year to achieve an optimal setting.

Although most patients still need to take medication after undergoing DBS, many patients experience considerable reduction of their Parkinson’s Disease symptoms and are able to greatly reduce their medications. The amount of reduction varies from patient to patient but can be considerably reduced in most patients. The reduction in dose of medication leads to a significant improvement in side effects such as dyskinesias (involuntary movements caused by long-term use of levodopa). In some cases, the stimulation itself can suppress dyskinesias without a reduction in medication.

At present, the procedure is used only for patients whose symptoms cannot be adequately controlled with medications.

Studies have shown DBS to be most effective in the treatment of intractable back pain. The rate of reduction in pain varies from patient to patient, but on average, pain is cut in half.

Unlike previous surgeries for Parkinson’s Disease, DBS does not damage healthy brain tissue by destroying nerve cells. This is important, for if more promising treatments are developed, the DBS procedure can be reversed.

Also, if a patient’s condition should change, the stimulation from the neurostimulator is easily adjustable and doesn’t require further surgery. Some people describe the stimulator adjustments as "programming."

Deep Brain Stimulation (DBS) carries the risks of major surgery. 

Also, depending upon usage, the battery in the neurostimulator must be replaced after three to five years, which requires complete replacement of the unit. This is necessary to maintain an uncontaminated field within the body.  Replacing the neurostimulator is a minor surgical procedure.

The remaining life of a battery may be reliably determined using a telemetric programmer, ensuring that the unit is replaced prior to battery failure.

This is an elective surgery, so there's no urgency in seeking treatment.