Imagine not being able to drink a cup of coffee without spilling it because of the trembling in your hands, struggling to fasten the buttons on your shirt, or your steps gradually slowing down. For thousands of patients living with Parkinson’s disease or a severe tremor problem, this is unfortunately an exhausting reality of daily life. However, thanks to advancing medical technology, there is a treatment method that patients call a “second spring”: commonly known as the brain pacemaker, and by its medical name, Deep Brain Stimulation (DBS).

So what exactly is this method, which frequently appears in the news and in which patients are treated while singing or chatting on the operating table? Let’s talk in the clearest possible terms about who the brain pacemaker is applied to, how it works, and the details of the surgical process.

What Exactly Is a Brain Pacemaker and How Does It Work?

We have all heard of cardiac pacemakers; they send electrical signals to regulate rhythm disorders in the heart. The brain pacemaker works on exactly this same principle.

In movement disorder diseases such as Parkinson’s, some cells deep within the brain become impaired and begin to produce incorrect, irregular electrical signals. This is reflected outwardly as trembling, stiffness, or slowing down. In brain pacemaker treatment, two electrodes (wires) as thin as a strand of hair are placed in these centers of the brain that produce the problematic signals. These wires are passed under the skin and connected to the main battery (the pacemaker), which is placed in the chest below the collarbone.

When the pacemaker is switched on, a continuous and regular electrical current is sent to that region of the brain. This current suppresses those “noisy and faulty” signals produced by the diseased cells. The system is somewhat like removing static from a radio and clarifying the channel.

Which Diseases Is It Used For?

The brain pacemaker is not a solution for every neurological disease. Today, we see the highest success rate in the following three disease groups:

Parkinson’s Disease: It is life-changing in patients for whom medication is no longer sufficient, in whom the side effects of medication (involuntary writhing and jerking movements) exhaust the patient, or in whom “on-off” fluctuations have become more frequent.

Essential Tremor (Familial Tremor): It is highly effective for stubborn hand tremors that increase with stress, excitement, or when trying to hold an object, making it impossible for the person even to drink soup or write.

Dystonia: This is a condition seen in certain regions of the body or throughout it, in which the muscles involuntarily and painfully contract, twist, or remain in a twisted position.

Is a Pacemaker Fitted to Every Parkinson’s Patient? (Who Is a Suitable Candidate?)

This is one of the most frequent questions asked by patients who come to our clinic. The brain pacemaker is not applied to every patient diagnosed with Parkinson’s at the initial stage. For a patient to be a suitable candidate for a brain pacemaker, the following conditions are required:

Generally, at least 4–5 years must have passed since the onset of the disease; the patient must initially have benefited from Parkinson’s medications (Levodopa) but over time the duration of the medication’s effect must have shortened; and there must be no severe psychiatric disorder or advanced dementia.

The decision for surgery is made by an expert council that includes a neurosurgeon, a neurologist, and a psychiatrist, as a result of detailed tests performed on the patient.

Is the Surgical Process Frightening? Why Is It Done While Awake?

The idea of brain surgery naturally makes patients anxious. However, one of the most interesting and reassuring aspects of brain pacemaker surgery is that the patient is awake during a large part of the operation.

Brain tissue itself has no pain receptors; that is, the brain does not feel pain. Only the scalp is numbed with local anesthesia. We chat with the patient throughout the operation. While placing the electrodes, we ask the patient to open and close their hand, drink water, or count numbers. Our aim is to observe live, with the low electrical current applied, that the trembling or stiffness stops at that very second, and to place the electrode at the most accurate point with millimetric precision. In the final stage, when the pacemaker is placed in the chest, the patient is put to sleep under general anesthesia.

How Does Life Change After Surgery?

A few days after the surgery is completed, the pacemaker’s settings are programmed individually with the help of a computer. Once the correct frequency is found, the patient’s tremors and stiffness decrease dramatically.

The patient can once again eat their own meals, get dressed, and go for a walk. The doses of medication used are significantly reduced, so the feeling of grogginess and the involuntary movements caused by the medication disappear. The lifespan of the pacemakers varies from 3 to 5 years depending on the model; with rechargeable pacemakers, this period extends up to 15–20 years. When the pacemaker runs out, the brain is not touched; only the battery in the chest is replaced in a small procedure lasting about 20 minutes.

Conclusion

To sum up, the brain pacemaker is not a treatment that completely eliminates (eradicates) the disease. However, it is a very powerful medical weapon that gives the patient back those old “independent days” that had been taken from them, the ability to move freely, and their quality of life — almost as if turning back time.

For any other questions on your mind, an assessment of your eligibility, and appointment scheduling, you can reach our team directly through our WhatsApp line.

Prof. Dr. Mehmet Şenoğlu — Specialist in Neurosurgery, İzmir

Disclaimer: This article has been prepared for general informational purposes only and does not substitute for medical diagnosis or treatment advice; for your complaints and the most appropriate treatment method, you must undergo a physical examination by a specialist physician.