It’s a surgery. A small device similar in size to a cardiac pacemaker gets implanted under the skin near the collarbone. Thin wires run from it up into specific regions of the brain. Those wires deliver continuous electrical pulses that interrupt the faulty signals causing tremors, stiffness, and the slowness of movement that Parkinson’s brings. It doesn’t cure the disease. Nothing does right now. But for patients whose symptoms have stopped responding well to medication, DBS can give back a level of function that drugs alone can’t.
Dr. Gurneet Singh Sawhney is a neurosurgeon at Fortis Hospital Mumbai with a dedicated fellowship in functional neurosurgery from Japan the subspecialty DBS belongs to. He’s assessed and operated on Parkinson’s patients from across India and abroad.
Wondering if DBS is the right step for you or someone in your family?
What Deep Brain Stimulation Actually Involves
People hear “brain surgery” and imagine the worst. The reality is more specific than that.
The device itself: A neurostimulator the actual pulse generator sits under the skin near the chest, same area a pacemaker would. It runs on a battery. It can be adjusted externally by the neurologist without another surgery. That adjustability matters a lot, because Parkinson’s changes over time and the settings need to change with it.
Where the wires go: Electrodes are placed in one of three brain targets depending on the patient’s dominant symptoms. The subthalamic nucleus is most common for Parkinson’s. The globus pallidus internus is used for certain symptom profiles. The thalamus gets targeted when tremor is the main problem. Choosing the right target is part of the pre-surgical evaluation it’s not the same for every patient, and getting it wrong means the surgery works less well than it should.
What the stimulation does: The electrical pulses essentially disrupt abnormal circuit activity in the basal ganglia the part of the brain that Parkinson’s damages. It doesn’t repair the damage. But it interrupts the signal pattern that’s causing the symptoms. Most patients see real reduction in tremor, rigidity, and those slow, shuffling movements. Some are able to reduce their medication dose. Not all. It varies by case.
The surgery itself: Usually done in two stages. Electrode placement first, then the pulse generator implant. Some centres do it awake so the patient can give real-time feedback during placement which improves accuracy. It’s done at Fortis Hospital, Mulund West, with full intraoperative neurophysiological monitoring. Patients looking at Deep Brain Stimulation surgery in Mumbai should understand that the centre’s setup matters as much as the surgeon’s training for this one.
Who Is Actually a Good Candidate for DBS
Not every Parkinson’s patient. This part gets skipped in most explanations and it really shouldn’t.
Patients whose symptoms respond to levodopa: This is the clearest predictor of DBS success. If levodopa works but the on off fluctuations have become unpredictable and hard to manage, that’s the profile DBS was built for. If levodopa never worked well, DBS usually won’t either.
Patients where medication has hit its ceiling: Years into treatment, the drug doses go up and the windows of good control get shorter. That’s when DBS becomes a serious conversation. Not before that point and not after the disease has progressed too far.
Patients without significant cognitive decline: DBS doesn’t help cognition and can sometimes worsen it in patients who already have memory or thinking problems. The pre surgical neuropsychological assessment exists for this reason. It’s not optional.
Patients who’ve been properly evaluated: Tremor alone isn’t enough of a reason. The full picture symptom profile, disease duration, imaging, medication history, cognitive testing all of it feeds into whether DBS is actually the right answer. Families reading about whether neurological problems can exist with normal scans sometimes come in with useful background already. It helps.
As a Neurosurgeon in Mumbai with subspecialty fellowship training in functional neurosurgery, Dr. Sawhney evaluates each Parkinson’s patient individually not against a checklist, against their actual case.
Why Choose Dr. Gurneet Singh Sawhney
DBS is a subspecialty procedure. That’s not a marketing line it’s just accurate. Most neurosurgeons don’t do it, and the ones who do vary enormously in how much of their practice it makes up.
Dr. Sawhney’s fellowship in functional neurosurgery was completed under Prof. Taira at Tokyo Women’s Medical University is one of the leading centres for this work globally. That’s where the DBS training came from. Not from occasional cases in a general neurosurgical practice. Back at Fortis Hospital Mulund West, the infrastructure backs it up with intraoperative monitoring, a dedicated neurosurgical team, and the ICU support that complex brain surgery requires. His evaluations don’t start from an assumption that surgery is the answer. They start from your history, your scans, your medication response, your daily symptoms. Some patients he sees aren’t ready for DBS yet. Some aren’t candidates. He’ll tell you that directly. And if you are a candidate, you’ll leave knowing exactly what the procedure involves for your case specifically not a general overview of it.
FAQ's
What is Deep Brain Stimulation used for in Parkinson's disease?
DBS reduces motor symptoms like tremor, rigidity and slow movement when medication stops providing consistent control, by delivering electrical pulses to specific brain regions through implanted electrodes.
Is Deep Brain Stimulation a cure for Parkinson's disease?
No, DBS doesn’t cure Parkinson’s or slow its progression; it manages symptoms by modulating faulty brain circuit activity, and results vary depending on the patient’s symptom profile and disease stage.
How long does a Deep Brain Stimulation surgery take?
The electrode placement procedure typically takes several hours and is often done awake for accuracy; the pulse generator implant is a separate, shorter procedure usually done a few days later.
Who is not a suitable candidate for DBS surgery?
Patients with significant cognitive decline, those whose symptoms don’t respond to levodopa, or those in very advanced disease stages are generally not suitable candidates for DBS.
How do I find out if I'm a candidate for DBS surgery in Mumbai?
Contact Dr. Gurneet Singh Sawhney at +91 8104310753 or gurneetsawhney@gmail.com he reviews records and imaging remotely before the consultation so the evaluation starts before you even come in.
References
- National Institute of Neurological Disorders and Stroke. Neurological Diagnostic Tests and Procedures. NINDS, NIH.
- Doraiswamy S, et al. Use of Digital Technologies in Facilitating Healthcare Access. PubMed Central, NCBI.