A Neurologist’s Guide to Deep Brain Stimulation in Parkinson’s Disease

Abstract

Deep brain stimulation (DBS) has emerged as a cornerstone therapy for people with Parkinson’s disease (PD) who experience motor fluctuations and dyskinesias refractory to optimized medical treatment. This narrative review provides a concise, clinically oriented overview of DBS tailored for neurologists, residents, and trainees involved in the evaluation and longitudinal management of advanced PD. The review discusses the evolution of DBS, contemporary patient selection criteria, approved stimulation targets, including the subthalamic nucleus, globus pallidus interna, and ventral intermediate nucleus of the thalamus, and the multidisciplinary presurgical workup. Practical aspects of surgery, device programming strategies, and expected clinical outcomes are highlighted, alongside an evidence-based discussion of risks, complications, and comparative effectiveness relative to other device-aided therapies. The central role of the neurologist, from early referral to long-term device management, is emphasized, as are recent advances such as directional leads, adaptive DBS, and sensing-enabled systems that are reshaping the therapeutic landscape. This review aims to equip neurologists with essential knowledge and decision-making tools to safely and effectively integrate DBS into clinical practice.