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By Mayo Clinic staff
During the surgery
Deep brain stimulation requires two surgical procedures:
- Surgery on your brain to implant electrodes
- Surgery on your chest to implant a neurostimulator device
Because the procedure is new and experimental for depression, it may not be performed exactly the same way everywhere. In general, here's how surgery for deep brain stimulation works.
Brain surgery. For the brain surgery portion, you're given local anesthetics to numb the areas being operated on. You remain awake and alert, however, so that the surgeon can talk to you to make sure the proper areas of your brain are being stimulated.
Your head is placed in a special frame to keep it still during surgery. Two holes are drilled in your skull. Guided by imaging techniques, the surgeon implants electrodes on both sides of your brain. You may undergo testing during the surgery to see how your mood is affected by the stimulation.
Chest surgery. During the second portion of surgery, the surgeon implants the neurostimulator in your chest, near your collarbone. You're put to sleep with general anesthesia for this surgery. Wires from the brain electrodes are placed under your skin and guided down to the battery-operated neurostimulator.
After the procedure
After the surgeries, you may need to take antibiotics to lower the risk of infection. A week or so after the surgeries, the neurostimulator in your chest is activated in your doctor's office. This sends electrical signals to the electrodes in your brain, affecting areas related to mood.
The amount of stimulation is customized to your situation, based on your mood and side effects. Stimulation is generally constant, 24 hours a day. The neurostimulator, which runs on battery power, can be easily programmed from outside your body.
You're given a hand-held magnetic device to use at home. With this, you can temporarily turn off stimulation by holding the magnet over the area of your chest where the neurostimulator is implanted. When you move the magnet away, stimulation restarts.
You must visit your doctor periodically to make sure that the neurostimulator is working correctly and that it hasn't shifted out of position. If necessary, the neurostimulator can be replaced or removed in a simple surgical procedure. The neurostimulator device may need replacement after a few years.
