Deep brain stimulation, also known as DBS, is a type of neurosurgical procedure first developed in 1987. The procedure itself uses a neurostimulator
Deep brain stimulation, also known as DBS, is a type of neurosurgical procedure first developed in 1987. The procedure itself uses a neurostimulator to treat a wide range of neurological disorders.
DBS or Deep brain stimulation involves the placement of a neurostimulator and electrodes into the patient’s brain. The neurostimulator sends electric signals, through the electrodes, to specific areas of the brain as part of the treatment process.
The neurostimulator, also called a brain peacemaker is placed under the skin in the patient’s upper chest area. The neurostimulator is connected to the electrodes through wires which travel under the patient’s skin. Deep brain stimulation works by regulating abnormal brain impulses through artificial electric signals. These electric signals may also correct or change the production of certain chemicals within the brain itself.
One of the biggest advantages to deep brain stimulation is the fact that the changes produced within the brain are fully controllable and reversible. If the patient faces certain unwanted side effects, the neurostimulator can be finetuned in order to provide the desired results.
Deep brain stimulation is widely used to treat Parkinson’s disease, obsessive compulsive disorders and even chronic pain.
It’s worthy to note that this technique is considered an option only after traditional treatment through medications has failed.
Although it’s not a relatively new procedure, DBS can only be used in certain cases where medication therapy has failed to alleviate symptoms. DBS can be used to treat the following conditions:
● Parkinson’s disease
● Essential tremor
● Chronic pain
● Major depression
● Obsessive compulsive disorder
Deep brain stimulation is also currently being tested as treatment for the following conditions:
● Tourette syndrome
DBS contraindications can include:
● Severe vascular disease
● Atypical Parkinsonism
● End stage Parkinson’s disease
● Age over 75
Patients must be well aware of the risks and benefits associated with deep brain stimulation surgery. The patient is required to pass several medical tests in order to ensure eligibility for the procedure. Once that’s done, an MRI is required in order to decide on the location where the electrodes are implanted.
Deep brain stimulation surgery consists of two parts:
Brain surgery – A head frame is created especially for the patient, in order to ensure that the patient’s head does not move during the procedure. Local anaesthesia is administered to the patient before an incision is made into the scalp. The surgeon will then implant a wire with four electrodes into the area of the brain which requires treatment. The wire will then lead to a neurostimulator. The neurostimulator acts as a generator for electric impulses to be sent into the brain.
Upper chest surgery – A few days after the brain surgery part of the DBS procedure is complete, the patient is put under general anaesthesia. The doctor will then implant the neurostimulator into the patient’s upper chest, often close to the collarbone. The stimulator is connected to the electrodes in the patent’s brain with wires underneath the skin. The generator or neurostimulator can be turned on or off by the patient at any given time.
Patients are required to avoid flying for at least 4 days after the DBS surgery. The incisions need to be kept dry for at least a week after the deep brain stimulation surgery. Most patients are able to return to normal activities in around 2-3 weeks.
Risks and complications associated with deep brain stimulation surgery can include:
● Bleeding within the brain
● Calcification of the implant
● Rejection of the neurostimulator
Deep brain stimulation side effects can include:
● Cognitive dysfunction
● Brain swelling
Deep brain stimulation surgery success rates depend heavily on the patient’s condition. For Parkinson’s disease, the success rate can be in the high 90s.
Patients will be required to visit their surgeon and neurologist, 4 weeks after the deep brain stimulation surgery. It’s important to note that deep brain stimulation surgery cannot fully treat diseases, but only alleviate symptoms. Results may differ from patient to patient.