Who is a candidate for deep brain stimulation? An introduction from Leo Verhagen, MD, PhD, Medical Director, Movement Disorders Surgery Program, Rush University Medical Center.
Click on the links to view sample intra-operative videos:
Microelectrode and DBS lead. The microelectrode is the thinnest of the two wires shown here. It is used to record nerve cell activity in the brain which helps to confirm the position of the target.
Next to the microelectrode is the actual DBS electrode (lead). At the very end four exposed "contacts" are visible, while the rest of the electrode is insulated. After the whole system has been implanted the clinician will determine which of these four contacts gives the most benefit.
Burr hole. At the start of surgery, the neurosurgeon will drill a nickel-sized hole (burr hole) in the skull, through which the DBS lead is inserted into the brain.
Lead down. The neurosurgeon advances the DBS lead towards the chosen coordinates of the target. The lead itself is barely visible (1.27 mm) and is held by a piece of precision equipment attached to the stereotaxic frame.
Good tap on left, tremor on right. Following implantation of the DBS lead in the right side of the brain (which controls the left side of the body), the left hand already shows improved finger tapping, whereas the right hand still shakes because the left lead has not been implanted yet.
Improved Speed of Movement. Following implantation of the DBS lead the right side of the brain (which controls the left side of the body), the left hand already shows improved speed of movement, whereas the right hand still shakes because the left lead has not been implanted yet.
Capped burr hole. After the lead is in place, a hard plastic cap closes the burr hole and holds the DBS lead in place. Subsequently the skin is closed.
Stapling skin. The skin over the capped burr hole is closed with staples.