Deep Brain Stimulation

Deep Brain Stimulation is the last resort for patients with Parkinson’s disease, commonly identified by trembling or shaking hands, loss of balance and coordination.

Deep Brain Stimualtion
DBS Image courtesy Michael J Fox Foundation

However Deep Brain Stimulation or DBS as it is called is not for every patient. DBS only helps patients who are still responsive to medication but are not able to achieve optimal efficacy in symptom management due to use over years.

With at least 90,000 implants worldwide, DBS today is the preferred choice for treatment of Parkinson’s disease.

DBS helps with problems of movement, tremors and involuntary movements associated with not only Parkinson’s disease but also dystonia, multiple sclerosis, severe psychiatric disorders such as OCD and even treatment-resistant depression.

What really happens in Deep Brain Stimulation?

During Deep Brain Stimulation surgery the patient is awake. A small battery-powered device pretty much like a pacemaker is implanted in the patient’s chest, near the collarbone or close to the abdomen. This device is connected to the electrodes in the brain by a wire. 
 
The device then sends electrical signals or impulses to target areas in the brain to help modulate dysfunctional circuits in the brain. These signals block the impulses that cause tremors, movement disorders, and other neurological dysfunction.
Due to stimulation and modulation, the brain is able to function more effectively.
 
Brain mapping gives us the exact location in the brain to be targetted, where nerve signals generate the tremors and other symptoms.

Imaging and recording technology maps the physical structure and functioning of the brain.

The surgery often takes several hours.

Side Effects of Deep Brain Stimulation can be, infection, swelling at the site of the implanted device, headache, confusion, stroke, seizure.

Advantages of DBS:

  • Continous symptom control , 24 x 7.
  • The patient can switch on and off the implanted device by a controller.
  • DBS can be performed on both sides of the brain to control symptoms on both sides of the body.
  • DBS is a reversible surgery unlike pallidotomy and thalamotomy
  • Symptoms of the patient can be controlled and stimulation adjusted specifically for each patient with DBS
  • The battery of the implanted device usually lasts for 3-5 years and post that can be recharged in what is known as a rechargeable device else the implanted device near the chest can be replaced in a small OPD procedure.
  • Many patients at an advanced stage of Parkinson’s, may benefit from Deep Brain Stimulation or DBS as it is called.

DBS cannot cure the disease but is able to provide significant and sustained relief to patients who have an erratic response to levodopa.

Tremors, however, can be controlled with Deep Brain Stimulation even for patients not responsive to levodopa treatment.

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DBS Image courtesy Michael J Fox Foundation

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