Deep Brain Stimulation

Deep Brain Stimulation is a technique used by functional neurosurgeons whereby electrodes are implanted into a target brain structure for the continuous administration of electrical stimulation. Electrodes are typically connected to an internal neurostimulator implanted under the skin, which can be tuned to an optimally therapeutic pulse width, frequency, and amplitude. A frequency of 30-60 Hertz is typically considered excitatory and can be used for electrical excitation of target structures. On the other hand, high frequency stimulation (HFS) using a frequency of greater than or equal to 100 Hertz is considered inhibitory and can take the place of more permanent techniques of structure ablation. Electrodes are typically inserted while the patient is awake and under local anesthesia using stereotaxic techniques. The brain target is localized using Magnetic resonance imaging (MRI), Ventriculography, Microrecording (MER), Microstimulation, and Macrostimulation and the electrode is implanted via the least disruptive path through less central brain structures. Most complications are mild and reversible. Psychophysiological side effects vary with site of implantation and surgical complications include skin infection, intracranial infection, and hemorrhage. ^[1]