Deep brain stimulation for Parkinson's disease: Surgical issues

Ali R. Rezai, Brian H. Kopell, Robert E. Gross, Jerrold L. Vitek, Ashwini D. Sharan, Patricia Limousin, Alim Louis Benabid

Research output: Contribution to journalReview articlepeer-review

149 Scopus citations


Numerous factors need to be taken into account when implanting deep brain stimulation (DBS) systems into patients with Parkinson's disease. The surgical procedure itself can be divided into immediate preoperative, intraoperative, and immediate postoperative phases. Preoperative considerations include medication withdrawal issues, stereotactic equipment choices, imaging modalities, and targeting strategy. Intraoperative considerations focus on methods for physiological confirmation of a given target for DBS electrode deployment. Terms such as microelectrode recording, microstimulation, and macrostimulation will be defined to clarify inconsistencies in the literature. Advantages and disadvantages of each technique will be addressed. Furthermore, operative decisions such as staging, choice of electrode and implantable pulse generator, and methods of device fixation will be outlined. Postoperative issues include imaging considerations, including magnetic resonance safety, device-device interactions, and immediate surgical complications pertaining to the DBS procedure. This report outlines answers to a series of questions developed to address all aspects of the DBS surgical procedure and decision-making with a systematic overview of the literature (until mid-2004) and by the expert opinion of the authors. This is a report from the Consensus on Deep Brain Stimulation for Parkinson's Disease, a project commissioned by the Congress of Neurological Surgeons and the Movement Disorder Society. It outlines answers to a series of questions developed to address all surgical aspects of deep brain stimulation.

Original languageEnglish
Pages (from-to)S197-S218
JournalMovement Disorders
Issue numberSUPPL. 14
StatePublished - 2006
Externally publishedYes


  • Deep brain stimulation surgery
  • Macrostimulation
  • Microelectrode recording
  • Microstimulation
  • Parkinson's disease
  • Stereotaxis
  • Surgical complications


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