REVIEW ARTICLE
Neurology
doi: 10.25005/2074-0581-2026-28-3-739-749
DEEP BRAIN STIMULATION IN PARKINSON'S DISEASE: A REVIEW OF EFFECTIVENESS, RISKS, AND PROSPECTS

F.A. YUSUPOV, M.SH. ABDYKADYROV

Osh State University, Medical Faculty, Osh, Republic of Kyrgyzstan

Deep brain stimulation (DBS) is one of the most effective surgical interventions for neurodegenerative diseases (NDDs), particularly Parkinson's disease (PD). Although the technique originated in the 1950s and 1960s to treat chronic pain and psychiatric disorders, modern advancements targeting the subthalamic nucleus (STN) and globus pallidus internus (GPi) regions have proven highly successful in mitigating akinesia, tremor, and other debilitating motor symptoms of PD. Despite being minimally invasive, the surgical procedure carries risks of acute complications, including hemorrhages, strokes, and infections. Furthermore, long-term follow-up studies have revealed potential adverse effects, such as weight gain, axial symptoms, speech impairment, and neuropsychiatric changes. These outcomes underscore the imperative for a multidisciplinary approach, rigorous patient screening, and personalized treatment selection to minimize risks and improve patients' quality of life.

This comprehensive review synthesizes the historical development, technical evolution, and current clinical applications of DBS. A literature search of Google Scholar, Scopus, PubMed, and Web of Science was conducted using relevant keywords and synonyms, including "deep brain stimulation", "neurodegenerative diseases", "Parkinson's disease", "subthalamic nucleus stimulation", "globus pallidus", "complications", and "side effects". We evaluated original research, review articles, and meta-analyses on DBS in NDDs, specifically PD, published primarily between 2015 and 2025.

Keywords: Parkinson's disease, neurodegeneration, deep brain stimulation, subthalamic nucleus, tremor, globus pallidus, substantia nigra.

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References
  1. Marzouk NH, Rashwan HH, El‑Hadidi M, Ramadan R. Proinflammatory and GABA eating bacteria in Parkinson's disease gut microbiome from a meta‑analysis prospective. NPJ Parkinsons Dis. 2025;11(1):145. https://doi.org/10.1038/ s41531-025-00950-z
  2. Katunina EA, Zalyalova ZA, Pokhabov DV, Putyatin IA. Tvorchestvo i creativnost’ pri bolezhni Parkinsona: zagadochnye effekty dofamina [Art and creativity in Parkinson’s disease: The mysterious effects of dopamine]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2025;125(4):13-20. https://doi.org/10.17116/ jnevro202512504113
  3. Yusupov FA, Yuldashev AA, Abdykadyrov MSh, Yusupova TF. Vliyanie mochevoy kisloty na progressirovanie bolezni Parkinsona: mif ili realnost’? [Effect of uric acid on the progression of Parkinson’s disease: Myth or reality?] Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2025;125(7):7-14. https://doi.org/10.17116/ jnevro20251250717
  4. Stocchi F, Bravi D, Emmi A, Antonini A. Parkinson disease therapy: Current strategies and future research priorities. Nature Reviews Neurology. 2024;20(12):695‑707. https://doi.org/10.1038/s41582-024-01034-x
  5. Fan HH, Hou NN, Zhang DL, Liu DN. Substantia nigra and blood gene signatures and biomarkers for Parkinson's disease from integrated multicenter microarray‑based transcriptomic analyses. Front Aging Neurosci. 2025;17:1540830. https://doi. org/10.3389/fnagi.2025.1540830
  6. Yusupov FA, Ydyrysov IT, Abdykadyrov MSh, Yusupova TF. Vozrastnye i gendernye aspekty bolezni Parkinsona [Age and gender aspects of Parkinson’s disease]. Klinicheskaya Meditsina. 2025;103(1):13-22. https://doi.org/10.30629/0023- 2149-2025-103-1-13-22
  7. Kopylova LI, Nikolaeva TY, Tappakhov AA, Popova TE. Vliyanie nemotornykh simptomov bolezhni Parkinsona na kachestvo zhizni patsientov [Influence of non-motor symptoms of Parkinson’s disease on patients' quality of life]. Zabaykal'skiy meditsinskiy vestnik. 2024;1:56‑61. https://doi. org/10.52485/19986173_2022_1_56
  8. Pfeiffer RF. Autonomic dysfunction in Parkinson's disease. Neurotherapeutics. 2020;17(4):1464‑79. https://doi.org/10.1007/s13311-020-00897-4
  9. Katunina EA, Ilina EP, Sadekhova GI, Gaysenyuk EI. Podkhody k ranney diagnostike bolezhni Parkinsona [Approaches to early diagnosis of Parkinson’s disease]. Zhur‑ nal nevrologii i psikhiatrii im. S.S. Korsakova. 2019;119(6):119‑27. https://doi. org/10.17116/jnevro2019119061119
  10. Kincl V, Panovský R, Bočková M, Rektor I. Parkinson´s Disease cardiovascular symptoms: A new complex functional and structural insight. Eur J Neurol. 2024;31(2):16110. https://doi.org/10.1111/ene.16110
  11. Chen R, Berardelli A, Bhattacharya A, Bologna M. Clinical neurophysiology of Parkinson's disease and parkinsonism. Clinical Neurophysiol Pract. 2022;7:201‑27. https://doi.org/10.1016/j.cnp.2022.06.002
  12. Karzhaubaeva MA, Sapargalieva AB, Rysbaeva AS. Bolezn' Parkinsona: kratkiy obzor i klinicheskoe nablyudenie [Parkinson’s disease: Ф brief review and clinical observation]. Aktual'nye problemy teoreticheskoy i klinicheskoy meditsiny. 2024;44(2):66-72. https://doi.org/10.24412/2790-1289-2024-2-66-72
  13. Marsili L, Bologna M, Miyasaki JM, Colosimo C. Parkinson's disease advanced therapies – a systematic review: More unanswered questions than guidance. Parkinsonism Relat Disord. 2021;83:132‑9. https://doi.org/10.1016/j. parkreldis.2020.10.042
  14. Hariz MI, Blomstedt P, Zrinzo L. Deep brain stimulation between 1947 and 1987: The untold story. Neurosurg Focus. 2010;29(2):1. https://doi. org/10.3171/2010.4.FOCUS10106
  15. Blomstedt P, Hariz MI. Deep brain stimulation for movement disorders before DBS for movement disorders. Parkinsonism Relat Disord. 2010;16(7):429‑33. https://doi.org/10.1016/j.parkreldis.2010.04.005
  16. Coffey RJ. Deep brain stimulation devices: A brief technical history and review. Artif Organs. 2009;33(3):208‑20. https://doi.org/10.1111/j.1525- 1594.2008.00620.x
  17. Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J. Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol. 1987;50(1‑6):344‑6. https:// doi.org/10.1159/000100803
  18. Rehncrona S, Johnels B, Widner H, Törnqvist AL, Hariz M, Sydow O. Long‑term efficacy of thalamic deep brain stimulation for tremor: Double‑blind assessments. Mov Disord. 2003;18(2):163‑70. https://doi.org/10.1002/mds.10309
  19. Siegfried J, Lippitz B. Bilateral chronic electrostimulation of ventroposterolateral pallidum: A new therapeutic approach for alleviating all parkinsonian symptoms. Neurosurgery. 1994;35(6):1126‑30. https://doi.org/10.1227/00006123- 199412000-00016
  20. Barbosa RMG, Soares MC, Portela DMMC, Guimarães TG, Cury RG. New perspectives of deep brain stimulation indications for Parkinson's disease: A critical review. Brain Sci. 2024;14(7):638. https://doi.org/10.3390/ brainsci14070638
  21. Bergman H, Wichmann T, DeLong MR. Reversal of experimental parkinsonism by lesions of the subthalamic nucleus. Science (New York, N.Y.). 1990;249(4975):1436‑8. https://doi.org/10.1126/science.2402638
  22. Aziz TZ, Peggs D, Sambrook MA, Crossman AR. Lesion of the subthalamic nucleus for the alleviation of 1‑methyl‑4‑phenyl‑1,2,3,6‑tetrahydropyridine (MPTP)‑induced parkinsonism in the primate. Mov Disord. 1991;6(4):288‑92. https://doi.org/10.1002/mds.870060404
  23. Benazzouz A, Gross C, Féger J, Boraud T, Bioulac B. Reversal of rigidity and improvement in motor performance by subthalamic high‑frequency stimulation in MPTP‑treated monkeys. Eur J Neurosci. 1993;5(4):382‑9. https://doi. org/10.1111/j.1460-9568.1993.tb00505.x
  24. Pollak P, Benabid AL, Gross C, Gao DM, Laurent A, Benazzouz A, et al. Effets de la stimulation du noyau sous‑thalamique dans la maladie de Parkinson. Revue Neurologique. 1993;149(3):175‑6.
  25. Limousin P, Pollak P, Benazzouz A, Hoffmann D, Le Bas JF, Broussolle E, et al. Effect of parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation. Lancet (London, England). 1995;345(8942):91‑5. https://doi.org/10.1016/s0140- 6736(95)90062-4
  26. Bril EV, Tomskiy AA, Gamaleya AA. Mesto DBS v lechenii bolezni Parkinsona [The role of DBS in the treatment of Parkinson's disease]. Byulleten' Natsional'nogo obshchestva po izucheniyu bolezni Parkinsona i rasstroystv dvizheniy. 2022;2:23- 5. https://doi.org/10.24412/2226-079X-2022-12428
  27. Harmsen IE, Wolff Fernandes F, Krauss JK, Lozano AM. Where are we with deep brain stimulation? A review of scientific publications and ongoing research. Stereo‑ tact Funct Neurosurg. 2022;100(3):184‑97. https://doi.org/10.1159/000521372
  28. Cai YZ, Zheng Y, Li W, Saffari SE, Ng HL, Zhan A, et al. Long‑term outcomes of subthalamic nucleus deep brain stimulation for Parkinson's disease in Singapore. Ann Acad Med Singap. 2024;53(8):481‑9. https://doi.org/10.47102/annalsacadmedsg.2023374
  29. Bucur M, Papagno C. Deep brain stimulation in Parkinson disease: A meta‑analysis of the long‑term neuropsychological outcomes. Neuropsychol Rev. 2023;33(2):307‑46. https://doi.org/10.1007/s11065-022-09540-9
  30. França C, Carra RB, Diniz JM, Munhoz RP, Cury RG. Deep brain stimulation in Parkinson's disease: State of the art and future perspectives. Arquivos de Neu‑ ro‑Psiquiatria. 2022;80(5 Suppl 1):105‑15. https://doi.org/10.1590/0004-282XANP-2022-S133
  31. Bratsos S, Karponis D, Saleh SN. Efficacy and safety of deep brain stimulation in the treatment of Parkinson's disease: A systematic review and meta‑analysis of randomized controlled trials. Cureus. 2018;10(10):3474. https://doi. org/10.7759/cureus.3474
  32. Choi JH, Kim HJ, Lee JY, Yoo D, Im JH, Paek SH, et al. Long‑term effects of bilateral subthalamic nucleus stimulation on sleep in patients with Parkinson's disease. PLoS One. 2019;14(8):221219. https://doi.org/10.1371/journal.pone.0221219
  33. Bove F, Mulas D, Cavallieri F, Castrioto A, Chabardès S, Meoni S, et al. Long‑term outcomes (15 years) after subthalamic nucleus deep brain stimulation in patients with Parkinson disease. Neurology. 2021;97(3): 254-62. https://doi.org/10.1212/ wnl.0000000000012246
  34. Hitti FL, Ramayya AG, McShane BJ, Yang AI, Vaughan KA, Baltuch GH. Long‑term outcomes following deep brain stimulation for Parkinson's disease. J Neurosurg. 2020;132(1):205‑10. https://doi.org/10.3171/2018.8.JNS182081
  35. Bang Henriksen M, Johnsen EL, Sunde N, Vase A, Gjelstrup MC, Østergaard K. Surviving 10 years with deep brain stimulation for Parkinson's disease – a follow‑up of 79 patients. Eur J Neurol. 2016;23(1):53‑61. https://doi. org/10.1111/ene.12614
  36. Gilbert F, Lancelot M. Incoming ethical issues for deep brain stimulation: When long‑term treatment leads to a new form of the disease. J Med Ethics. 2021;47(1):20‑5. https://doi.org/10.1136/medethics-2019-106052
  37. Petersen JJ, Kamp CB, Faltermeier P, Juul S, Løkkegaard A, Gluud C, et al. Deep brain stimulation for Parkinson's disease: Systematic review with meta‑analysis and trial sequential analysis. BMJ Medicine. 2024;3(1):705. https://doi. org/10.1136/bmjmed-2023-000705
  38. Likhachyov SA, Alekseevets VV, Bunyak AG. Oslozhneniya i pobochnye effekty glubokoy stimulyatsii mozga u patsientov s bolezn'yu Parkinsona [Complications and side effects of deep brain stimulation in patients with Parkinson's disease]. Nevrologiya i neyrokhirurgiya. Vostochnaya Evropa. 2018;8(1):38‑48.
  39. Aidarov SA, Mammadinova IZ, Nurakay NA, Nurimanov CS. Retrospective analysis of the effectiveness of deep stimulation of the subthalamic nuclei in Parkinson's disease. Neyrokhirurgiya i Nevrologiya Kazakhstana. 2024;75:20‑9.

Authors' information:

Yusupov Furkat Abdulakhatovich,
Doctor of Medical Sciences, Full Professor, Head of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty, Osh State University
Scopus ID: 57194719351
ORCID ID: 0000-0003-0632-6653
SPIN: 7415-1629
Author ID: 1047873
E-mail: furcat_y@mail.ru

Abdykadyrov Mukhammadyusuf Shkuratovich,
Postgraduate Student, Assistant at the Department of Neurology, Neurosurgery, and Psychiatry, Medical Faculty, Osh State University
Researcher ID: LMP-2727-2024
Scopus ID: 59677073200
ORCID ID: 0000-0001-5549-3832
SPIN: 5384-7010
Author ID: 1116061
E-mail: aratingo@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Abdykadyrov Mukhammadyusuf Shkuratovich
Postgraduate Student, Assistant at the Department of Neurology, Neurosurgery, and Psychiatry, Medical Faculty, Osh State University

723500, Republic of Kyrgyzstan, Osh, Lenin str., 320

Tel.: +996 (999) 565637

E-mail: aratingo@mail.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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