The latest breakthrough for neurological disorders such as Parkinson’s Disease is Deep Brain Stimulation or DBS. The diseased brain sends abnormal impulses to the body, causing the tremors and mobility issues that characterize the disease. DBS, a surgical procedure, places electrodes directly into certain areas of the brain to help those areas function better. This method is typically reserved for patients that have exhausted every other type of therapy available, including medication.
What Are the Risks?
As with any surgical procedure, there are risks involved with DBS. The most concerning risk is that of a stroke, which can cause permanent issues and even death. The risk level for a stroke is just 1 percent, however. In addition, there is the risk of infection, which is between a 2 and 5% risk, as well as the risk of bleeding on the brain. Patients are always encouraged to weigh the pros and cons of every surgical procedure and because of the risk of stroke or infection, it is vital that every other method is exhausted first.
How DBS Works
Deep Brain Stimulation does not block any healthy nerve cells or brain tissue; it compensates for the damaged electrical signals that the brain sends to certain parts of the body. In order to do this, a neurostimulator is placed in the chest area, near the collarbone. According to The National Parkinson’s Foundation, the device is similar to a pacemaker. It is the size of a standard stopwatch and operates on batteries which need to be changed every three to four years. The device sends nerve signals via electrical stimulation to the targeted areas of the brain via the electrodes that are surgically placed in the brain. The most common areas of the brain that are targeted include:
- Subthalamic nucleus
- Globus Pallidus
All of the inner workings of the system are inside the body. No telltale wires hang outside of the body. As the system needs adjusting, a doctor can do so in the office with a computer that programs the system.
Other Uses for DBS
DBS is most commonly known for its usefulness for patients with Parkinson’s Disease that is unmanageable with medication. There are a few other uses for this treatment too, including:
- Essential Tremor – A disorder that causes tremors or shaking, typically in the hands
- Dystonia – A muscle contraction disorder that can cause odd posture or difficulty with movement
- Tourette Syndrome – A neurological illness that causes vocal tics and unplanned movements
- OCD – Obsessive Compulsive Disorder causes patients to experience incredible impulsivity and obsessions
The uses of DBS on these illnesses and disorders are limited, but studies continue to see if there are ways to benefit patients who suffer from these issues.
The Parts of the System
There are three components of DBS. They include:
- Lead – The lead is inserted into the brain during the brain surgery component of the process. During this procedure, most patients are awake as the surgeon conducts brain mapping to find the areas where the nerve signals are damaged and need replacing with the electrodes. The leads are placed via a tiny opening in the skull.
- Extension – From the lead is an extension, like an extension cord. The wire goes from the brain through the head and down to the chest wall where the stimulator is placed for proper functioning.
- Neurostimulator – The “brains of the operation” is the neurostimulator, which is placed in the chest wall. Most surgeons place it directly under the collarbone; this is the component that needs to be maintained by a doctor and the batteries replaced every few years.
Typically, patients who have taken medications for Parkinson’s Disease are the best candidates for the procedure. Surgeons typically look for patients who have suffered from Parkinson’s Disease complications for at least five years; whose daily live are affected; and who have taken a combination of medications with limited success. DBS does not replace the need for Parkinson’s medications; it reduces the need, however, and helps to improve the daily life of a person with this disease.
It is important to talk about the risks with a doctor. As with any surgical procedure, there is no way to predict exactly what will occur with any individual patient. Pros and cons must be weighed to determine the rightness of the treatment. As mentioned, for those suffering from a condition other than Parkinson’s Disease, studies are still being conducted on the effectiveness and prognosis for these conditions. Talking to a doctor about every option available can help people make the best decisions as to health and treatment.
Centers of Excellence, University of Pittsburgh. Deep Brain Stimulation for Movement Disorders. Neurological Surgery. Epilepsy and Movement Disorders Program. Available at http://www.neurosurgery.pitt.edu/centers-excellence/epilepsy-and-movement-disorders-program/deep-brain-stimulation-movement-disorders. Retrieved from July 18, 2016.
National Parkinson’s Foundation. Deep Brain Stimulation. Available at http://www.parkinson.org/understanding-parkinsons/treatment/surgery-treatment-options/Deep-Brain-Stimulation. Retrieved on July 18, 2016.
Perlmutter, J. S., Mink, J. W. (2006). Deep Brain Stimulation. Annual Reviews, Neuroscience, 29: 229-257. National Center for Biotechnology Information, U.S. National Library of Medicine.
Availableat http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518728/. Retrieved on July 22, 2016.