The brain doesn't recognize whether the neuron is destroyed or simply shut down. The structure is no longer working and the tremor goes away. The single most important advantage of DBS is that it is reversible. Based on a patient's needs, the electrode can be turned on and off, the voltage adjusted, or new contacts or a different combination of contacts can be used. If unwanted side effects remain, the electrode can be removed.
Side effects are rare but can include painful sensations, paralysis, or brain hemorrhage.
In concert with advanced anatomical imaging, single cell micro-electrical recordings allow surgeons to target the brain more specifically. The different firing rates of the associated cells define where they are in the brain relative to the targeted structure. These sounds are recorded through an electronic probe that is carefully lowered into that region through a small hole in the patient's skull and fed back to the surgical team. In DBS, once the desired site is detected, the surgeon replaces the recording electrode with the stimulating electrode, completing the first stage of the procedure. The following day the electrode is connected to an external stimulator which allows the surgical team to identify the best stimulation parameters.