Principles of Electrophysiology
In many ways, post-operative DBS programming is “prescribing electricity” in much the same sense as “prescribing medications.” The principles of pharmacokinetics and pharmacodynamics that guide the rational use of medications find parallels in DBS. Many drugs have their effect by binding to ligand-gated channels, particularly channels that control the flow of electrical charges, in the form of ions across the cell membrane of the neuron in the soma. The binding of drugs to receptors can open the receptor to approximate the normal opening by endogenous neurotransmitters, or to block the channel from opening when endogenous neurotransmitters are released. In the case of DBS, the electrical charges manipulated in the nervous system similarly affect neuronal membrane channels; however, these initially and primarily are voltage gated ionic conductance channels, which are described in detail in this chapter.