Is DBS Surgery Safe for Parkinson's Disease?

By Prof. Dr. Paresh Doshi — Director, Stereotactic & Functional Neurosurgery, Jaslok Hospital, Mumbai. Performed India’s first DBS surgery in 1998; 750+ DBS procedures over 30 years.

Short answer: Yes — for appropriately selected patients, DBS surgery is safe. Like any surgery or medical treatment, it carries some risk of side effects and complications. If your doctor hasn’t walked you through those risks in detail, that conversation isn’t finished yet. Below is the same explanation I give my own patients and their families.

As a patient, you can’t eliminate risk — no surgery is risk-free — but you can be well informed and choose a surgeon and a level of risk you’re genuinely comfortable with. That starts with understanding, specifically, what can go wrong.

What Are the Risks of DBS Surgery?

DBS risk falls into two distinct categories, and it’s worth keeping them separate because they’re managed differently: immediate surgical complications from the operation itself, and delayed side effects that come from stimulation — usually from DBS programming that hasn’t yet been fine-tuned.

Surgical Complications

There are three complications that matter most:

  • Hemorrhage (bleeding) — when it happens, it can occasionally be serious, but in the large majority of cases it’s inconsequential and resolves without lasting effect.
  • Infection — this can mean a longer recovery, and in some cases requires removing the implanted hardware and reimplanting at a later date once the infection has cleared.
  • Inaccurate lead placement — where the electrode isn’t positioned precisely enough to give full benefit, which can affect how well the therapy works.

How We Measure and Reduce This Risk at Jaslok Hospital

The first step in managing any risk is measuring it honestly and publishing the results — not just making claims. We’ve done this twice, eleven years apart, as our experience grew:

  1. 2011 — our first published complication series. In Stereotactic and Functional Neurosurgery, we reported our surgical and hardware complication rates across our first 153 DBS patients (298 electrodes), operated between 1999 and 2009.
long term surgical and hadware related compilacations of dbs
  1. 2022 — the long-term picture, 519 cases over 20 years. In Neuromodulation: Technology at the Neural Interface, we published a 20-year analysis (1999–2019) of 519 DBS patients (1024 electrodes) and 232 battery-replacement procedures. The most important finding: our complication rate fell from 23% in our first 100 cases to 7% in our most recent 100 cases — a statistically significant drop (p<0.0001) — and there was no mortality across the entire series.
Surgical and Hardware Complications of Deep Brain Stimulation

Doshi PK, Rai N, Das D. “Surgical and Hardware Complications of Deep Brain Stimulation — A Single Surgeon Experience of 519 Cases Over 20 Years.” Neuromodulation. 2022;25(6):895–903. doi:10.1111/ner.13360.

That drop is the clearest evidence of what experience actually does to risk: it isn’t a claim, it’s a measured, published result. It’s also why this work gets invited internationally — most recently a lecture on minimizing DBS complications, delivered at Mayo Clinic in June 2026.

Risks Related to DBS Programming

The second category of risk has nothing to do with the surgery itself — it comes from how the device is programmed afterward. Stimulation settings that are too aggressive, or not yet correctly tuned, can occasionally produce mood, impulse-control, or personality changes. These are real, they’re published in the medical literature, and knowing about them in advance is part of being properly informed — not a reason to be alarmed.

We’ve published on this transparently, including cases from our own practice:

  1. Hypersexuality following stimulation (2008). A case report in Neurology India describing hypersexuality as a stimulation side-effect, and how it was recognized and managed through programming adjustment.

Doshi P, Bhargava P. “Hypersexuality following subthalamic nucleus stimulation for Parkinson’s disease.” Neurol India. 2008;56(4):474–476.

  1. Depression and a suicide attempt following stimulation (2002). Published in Movement Disorders — one of the earliest published cases of its kind, describing depression that emerged after bilateral subthalamic nucleus stimulation, and reinforcing why psychiatric monitoring is built into our post-operative programming protocol.

Doshi PK, Chhaya N, Bhatt MH. “Depression leading to attempted suicide after bilateral subthalamic nucleus stimulation for Parkinson’s disease.” Mov Disord. 2002;17(5):1084–1085. Full text: neurologicalsurgery.in/wp-content/uploads/2025/01/Depression-leading-to-suicide-following-STN-DBS.pdf

[Kareena/Ankit: I couldn’t capture a clean title screenshot for this one — Chrome’s PDF viewer blocked it. Please grab a screenshot directly from the PDF at the link above.]

  1. Mania induced by stimulation (2016). Published in Stereotactic and Functional Neurosurgery — a case from our DBS-for-OCD program (not a Parkinson’s case), describing mania induced by stimulation and how it resolved with programming adjustment. Included here because it’s part of the same body of work: publishing what we see, not just what goes well.

Doshi PK. “Mania Induced by Stimulation following DBS of the Bed Nucleus of Stria Terminalis for Obsessive-Compulsive Disorder.” Stereotact Funct Neurosurg. 2016;94(5):326.

[Note to Paresh: you mentioned a recent paper on anodic stimulation as the latest in this series — I searched but couldn’t confirm the exact citation under your name; please send the title/journal so it can be added correctly rather than guessed at.]

Jaslok’s DBS programming team is recognized as one of a small number of centers of excellence for DBS programming by a leading device manufacturer — worth naming directly once you confirm which manufacturer you’d like credited.

How to Evaluate Any DBS Surgeon Before You Choose

Beyond any one hospital’s numbers, here are three questions worth asking whoever you’re considering:

  1. Experience. There’s no substitute for it. The data above shows why: complication rates fall meaningfully as a surgeon’s cumulative case count grows. Ask how many DBS surgeries — specifically DBS, not general neurosurgery — your surgeon has personally performed.
  2. Consistency. Has your surgeon been at one hospital consistently, or moved between several? Building an experienced team around a DBS program takes years at a single center — that continuity is hard to replicate by moving institutions. It’s also worth asking whether DBS is a primary focus or one of many procedures they perform; depth of focus tends to show up in outcomes.
  3. Transparency and course correction. Has the surgeon published their own complication data, the way the papers above do — or only made claims without evidence? A surgeon who tracks and publishes their own results, including the ones that didn’t go perfectly, is actively course-correcting. Tall claims with no published data behind them are worth treating with caution.

Frequently Asked Questions

What are the main risks of DBS surgery?

The main surgical risks are hemorrhage, infection, and inaccurate lead placement. Separately, stimulation/programming can occasionally cause mood or behavioral side effects, which are managed by adjusting the device settings.

How common are complications?

In our own 20-year, 519-case series, the complication rate fell from 23% in the first 100 cases to 7% in the most recent 100 cases, and in the last 300 patients, we virtually had no complications and no mortality in our series, — in line with published international data showing DBS is safe with acceptably low complication rates.

Can side effects from DBS programming be managed?

Yes. Stimulation-related side effects such as mood changes are typically identified during follow-up programming visits and resolved by adjusting stimulation settings.

How do I choose a safe, experienced DBS surgeon?

Ask about their personal DBS case volume (not general neurosurgery volume), whether they’ve operated consistently at one center, and whether they’ve published their own outcomes and complication data.

 

Drafted from Dr. Doshi’s brief, with all publication details verified against PubMed/Karger before inclusion. Two items above need his confirmation before this goes live: the anodic stimulation citation, and the device manufacturer name for the “center of excellence” line.