The Timeline of Deep Brain Stimulation
Elise Claux
Introduction
Deep Brain Stimulation (DBS) has become a cornerstone of modern neurosurgery. It has transformed how clinicians treat a variety of neurological and psychiatric disorders. Today, DBS is used to manage conditions such as Parkinson’s disease, essential tremors, dystonia, obsessive-compulsive disorder (OCD), epilepsy, and research continues into many more potential applications.
DBS wasn’t invented overnight. It emerged through decades of technological innovation and clinical evolution. Below, we trace the history of DBS from its early roots in the exploration of the brain and stereotactic surgery to its current role as an established therapy.
Timeline
1890- 1940s: Exploration of the Brain
The history of DBS begins with efforts to understand the brain through electrical stimulation and surgical interventions. In 1890, Sir Victor Horsley performed the first removal of the motor cortex to treat involuntary movement disorders. This laid the foundations for neurological surgery.
By the 1930s, clinicians were exploring, with electrical probes in surgery, to map brain out function. The neurosurgeon Wilder Penfield tried treating epilepsy by stimulating different areas of the brain with an electrical probe during an awake surgery. This method aimed at finding areas responsible for epileptic seizures before destroying them. (1)
1947- 1960s: Stereotactic Surgery and Early Stimulation
In 1947, the neurologist Spiegel and neurosurgeon Wycis introduced a stereotactic apparatus, a tool that let surgeons precisely target deep brain structures by visualizing the brain precisely. This breakthrough made minimally invasive brain surgery safer and more accurate. It reduced mortality rates from around 15% to as low as 1%. Stereotactic techniques were soon used for both lesioning and stimulation research in movement disorders, chronic pain, and psychiatric conditions.
During the 1960s, researchers observed that high-frequency electrical stimulation reduced tremors and other motor symptoms, while low frequencies sometimes worsened them. In 1963, Albe Fessard and his team first reported symptom improvement by stimulating the ventral intermediate (VIM) nucleus of the thalamus in Parkinsonian patients, a deep structure in the brain.
1960s- 1970s: Technological Growth and Temporary Decline
The 1960s brought new hardware developments. Medtronic, a medical device company, introduced the first battery-operated wearable pacemaker. From this success, early adaptations of pacemakers for neurological use were first attempted to treat chronic pain. (2) Norman Shealy and Hosobuchi were one of the first to implant electrodes into the thalamus to alleviate pain. (3)
By 1968, more than 25 000 stereotactic surgeries were performed to treat Parkinson’s disease. Furthermore, the main target for DBS in Parkinson’s disease was identified: the Sub-thalamic Nucleus (STN), a small lens shaped nucleus in the brain. However, the introduction of levodopa, a highly effective medication for Parkinson’s disease, in the late 1960s, caused a shift away from surgical treatments, including DBS. The reasons being that levodopa was inexpensive, safe, and remarkably improved symptoms. It wasn’t until the late 1980s that they discovered that levodopa’s effectiveness was reduced in the long run and had side effects such as dyskinesia.
In 1971, psychiatrist Peter Breggin spoke to a U.S. Senate subcommittee, arguing that psychosurgery, including deep brain stimulation, lacked a scientific basis, could harm normal brain tissue and be misused to control individuals. His claims raised ethical concern and political debate about brain surgery. Even though the government review found that DBS could benefit patients, this controversy discouraged many surgeons who abandoned the field. The research was slowed to a few specialized academic centers in the U.S. and Europe.
Despite this, research continued. In 1975, Medtronic officially established a neurological division and began trademarking the term “Deep Brain Stimulation”. However, the technology still faced limitations such as lead complications and a short battery life.
1980s- 1990s: Modern DBS Emerges
In 1976, the FDA (US Food and Drug Administration) was granted authority over all medical devices. This meant that medical devices need to be proved safe and effective before being put on the market. While this initially slowed the spread of DBS, it also required researchers to develop standardized surgical techniques and formal clinical trial protocols. These regulatory requirements needed high-quality studies, which ultimately led to the 1987 trials.
French neurosurgeon Alim-Louis Benabid and his colleagues, in the 1987 trials, showed that high-frequency stimulation of the VIM (ventralis intermedius) nucleus could safely control tremors. This discovery was crucial in shifting from lesion based procedures to stimulation based procedures.
1997- 2018: Clinical Approval and Expansion
1997: The U.S. Food and Drug Administration (FDA) approved DBS targeting the VIM nucleus for essential tremor and Parkinson’s tremor.
2002: FDA expanded approval to include Parkinson’s disease treatment targeting other structures in the brain such as STN and GPi (Internal globus pallidus) for motor complications.
2003: A Humanitarian Device Exemption (HDE) allowed DBS to be used for dystonia.
2009: DBS received an HDE for obsessive-compulsive disorder (OCD). This was the first non-movement disorder psychiatric indication. (2)
2018: DBS was approved for epilepsy. It reduces the frequency of partial onset seizures for patients who are drug resistant. (4)
2025- …: The Future of DBS
Over the last two decades, DBS has been used in hundreds of thousands of patients worldwide. There is currently ongoing clinical research into additional indications like depression, eating disorders, pain, and cognitive conditions.
The traditional DBS system, also known as open loop DBS, delivers continuous stimulation. Newer approaches like adaptive or closed-loop DBS are emerging. These systems can adjust stimulation in real time based on ongoing brain activity. This aims for a more personalized and efficient therapy. Some of these adaptive systems have recently received regulatory approval, for example, Medtronic with Parkinson’s disease in 2025 (6).
Conclusion
Deep brain stimulation emerged from decades of experimentation, debate, and technological refinement. Its progress was shaped not only by neuroscience, but also by ethical concerns, political scrutiny, and regulatory oversight. These challenges slowed its development at times, but ultimately ensured that DBS evolved into a therapy that is both effective and evidence based.
Today, DBS is a well-established treatment for several movement and psychiatric disorders. It offers symptom relief to patients who no longer respond to medication alone. Ongoing research into adaptive stimulation, new brain targets, and long-term outcomes suggests that DBS will continue to expand as a scientific therapy. (5)
Miocinovic, S., Somayajula, S., Chitnis, S., & Vitek, J. L. (2012). History, applications, and mechanisms of deep brain stimulation. JAMA Neurology, 70(2), 163. https://doi.org/10.1001/2013.jamaneurol.45
Gardner, J. (2013). A history of deep brain stimulation: Technological innovation and the role of clinical assessment tools. Social Studies of Science, 43(5), 707–728. https://doi.org/10.1177/0306312713483678
Pycroft, L., Stein, J., & Aziz, T. (2018). Deep brain stimulation: An overview of history, methods, and future developments. Brain and Neuroscience Advances, 2, 2398212818816017. https://doi.org/10.1177/2398212818816017
Brain stimulation therapies for epilepsy. (n.d.). National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/about-ninds/what-we-do/impact/ninds-contributions-approved-therapies/brain-stimulation-therapies-epilepsy
Xin, T. (2025, February 10). Deep brain Stimulation (DBS) : A leap from history to the future. https://qianfoshan.internationalhealthcarereview.com/index.php/ihsj/article/view/6
Medtronic earns U.S. FDA approval for the world’s first Adaptive deep brain stimulation system for people with Parkinson’s. (2025, February 24). Medtronic News. https://news.medtronic.com/2025-02-24-Medtronic-earns-U-S-FDA-approval-for-the-worlds-first-Adaptive-deep-brain-stimulation-system-for-people-with-Parkinsons
