Dr. Pedro Roldán Ramos
Neurosurgeon · Functional surgery, DBS and HIFU · Professor at the UB
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Neuromodulation
Deep Brain Stimulation (DBS)
Deep Brain Stimulation for the treatment of Parkinson's disease, essential tremor, dystonia and refractory epilepsy. Reversible, adjustable technique that does not destroy tissue.
What is it?
A personalised "brain pacemaker"
DBS implants thin electrodes in specific brain structures connected to a subcutaneous generator. The electrical impulses modulate neural circuits to correct their malfunction, reducing symptoms without destroying tissue.
"Deep brain stimulation is the reference treatment for Parkinson's disease with fluctuating response to levodopa, refractory essential tremor and generalised dystonia."
Indications
- Parkinson's disease with motor fluctuations and dyskinesias.
- Essential tremor refractory to medication.
- Dystonia: generalised or cervical.
- Epilepsy: refractory cases in selected patients.
Additional information for patients: manufacturer leaflets on DBS therapy on the Boston Scientific portal: estimulacion-cerebral-profunda.es. This link is informational and does not imply commercial endorsement.
How it is done
Step by step of DBS implantation
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1 · Multidisciplinary assessment
Joint evaluation with neurology. In Parkinson's, an L-dopa challenge test is performed; in dystonia and tremor, specific motor scales are applied. Prior neuropsychological and psychiatric assessment.
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2 · Stereotactic planning
High-resolution brain MRI fused with CT on the day of surgery. Millimetric calculation of the target (STN for Parkinson's, VIM for tremor, GPi for dystonia) and the trajectory to avoid blood vessels.
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3 · Electrode implantation
Electrode placement under stereotactic guidance (frame or frameless). Intraoperative neuronal microrecording to confirm the correct target. Clinical test with the awake patient to verify improvement and rule out adverse effects.
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4 · Generator (IPG) implantation
In the same operation or 2-4 weeks later: placement of the pulse generator below the clavicle with a subcutaneously tunnelled cable from the scalp.
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5 · Initial programming
Activation and progressive programming in clinic 2-4 weeks after implantation. Periodic parameter adjustments (amplitude, frequency, pulse width, active contact) during the first 6-12 months.
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6 · Coordinated follow-up
Joint reviews with neurology. Stimulation adjustments and progressive reduction or withdrawal of medication are planned as a team.
Video · short explanations
Deep brain stimulation explained by Dr. Pedro Roldán
Team
Functional neurosurgery and movement disorder neurology
The management of Parkinson's disease, tremor and movement disorders combines functional surgery (HIFU, DBS) with specialist movement disorder neurology assessment, both before and after the procedure.
Dr. Gabriel Salazar Tortolero
Neurologist · Parkinson's disease, tremor and movement disorders
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Locations
Where we treat deep brain stimulation (DBS)
Surgical procedures are carried out in operating theatres equipped with the technology required for deep brain stimulation (DBS). Your first consultation and follow-up can take place at any of our centres in Barcelona.
Operating theatre
★ Operating theatre
Hospital El Pilar
★ Operating theatre
Barnaclínic+
Consultation and follow-up
Consultation
Centro Médico Aribau
Consultation
Clínica Olivé Gumà
Patient reviews
What our patients say
High-grade glioma
"I arrived with a glioma I had been told was inoperable. Here they reviewed it at the tumour board and offered me a plan. The surgery was a success. Four years on, I am well."
Cervical disc herniation
"For years I had a cervical disc herniation, operated on by another team with no improvement. Minimally invasive surgery gave me back my mobility and took the pain away."
International patient
"I travelled from outside Spain. The team reviewed my case before I came and gave me a clear plan. Caring people and impeccable technique."
Request information
Are you a candidate for DBS?
Send us your reports and we will review your case in a multidisciplinary committee (neurology and functional neurosurgery).