What To Expect

You will remain in the hospital for several days after the procedure while your doctor checks the effect of deep brain stimulation.

How Well It Works

Deep brain stimulation of the thalamus is effective in reducing tremor. It does not affect slow movement (bradykinesia), stiffness (rigidity), or other symptoms.^{footnote 1}

Compared to medicine for Parkinson’s disease, DBS of either the subthalamic nucleus (STN) or globus pallidus (GPi) gave people almost 5 more hours of “on” time on average each day.^{footnote 2}

Two studies comparing DBS of the STN to DBS of the GPi showed equal effects on the symptoms of Parkinson’s disease after 2 and 3 years.^{footnote 3, footnote 4}

• The group who had DBS of the STN was able to take less medicine for Parkinson’s disease after 2 or 3 years compared to the group who had DBS of the GPi.
• After 2 years, the group who had DBS of the GPi had less depression and problems thinking than the group who had DBS of the STN. But after 3 years, there was no difference in depression between the two groups.
• Quality of life was similar between the two groups.

What To Think About

A neurologist with special training in Parkinson’s disease is most often the best kind of doctor to make a decision about deep brain stimulation. If you might benefit from the operation, your neurologist can refer you to a brain surgeon with experience doing the surgery.

Deep brain stimulation may be considered as an addition to levodopa therapy, not a replacement for it. It does not cure Parkinson’s disease and does not eliminate the need for medicine. The surgery can help maintain and extend the benefits of levodopa therapy. But it should not be considered for people with Parkinson’s disease who also respond poorly to levodopa therapy.

Because of an increased risk of falling in people who have DBS, it’s a good idea to understand the ways you can prevent falls after the surgery.

One of the possible advantages of deep brain stimulation over “lesional” surgery for Parkinson’s disease (such as pallidotomy) is that it can be changed or reversed. The effects of lesional surgery, which involves creating a lesion or intentionally destroying a small portion of the brain, are permanent, but the electrodes used in deep brain stimulation can be adjusted, turned off, or removed if they cause problems.

Deep brain stimulation for tremor caused by multiple sclerosis (MS) is still experimental, expensive, and not widely available.