August 7, 2020

Deep Brain Stimulation: Hope Through Research for Neurologic Disorders

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What is DBS?

DBS is a way to modulate parts of the brain that cause disabling conditions such as Parkinson's disease without damaging the brain. Electrodes are placed within certain regions of the brain known to control movement, such as in the thalamus (to treat essential tremor and other forms of tremor) or in the globus pallidus (for Parkinson's disease and dystonia). These electrodes are then connected by small wires to a battery-powered device called an impulse generator, which is surgically implanted under the skin of the chest wall, just below the collarbone. When activated, the impulse generator sends electrical pulses to the target areas in the brain, blocking the brain’s own impulses that cause tremors or other involuntary movement symptoms.

Key Points:

  • ment disorders such as Parkinson’s disease, essential tremor and dystonia.
  • Recent studies suggest DBS may help with symptoms associated with Alzheimer’s disease, Tourette’s syndrome, and obsessive-compulsive disorder.
  • Potential DBS candidates must first obtain an accurate diagnosis.
  • Deep brain stimulation, or DBS, is a therapy that offers relief from various move

Rewiring the brain with DBS

Put simply, the brain is composed of three main parts-- the cerebrum, cerebellum, and brainstem. Within these key sections, there is a left and right hemisphere, gray matter, white matter, connecting fibers, and those 100 billion neurons. One of the benefits of studies in brain mapping and DBS includes a newfound ability to explore and manipulate different regions and parts of the brain.

Deep Brain Stimulation: How It Works

A surgeon implants a small battery operated device similar to a pacemaker under the skin near the collar bone. The doctor then positions wires from the device with electrodes on their ends in areas of the brain that control motor function. Usually a person remains awake during surgery so that he or she can answer questions and perform certain tasks to make sure that the electrodes are positioned correctly. The device works by electrically stimulating these areas and blocking the abnormal nerve signals that cause the tremor in Parkinson’s disease patients.

Most people with Parkinson’s disease will require the surgery be done on both sides of the brain.The procedure is performed with the patient awake to ensure optimal placement of the electrodes and maximize the potential for benefit. A few weeks after surgery, a movement disorder specialist uses a handheld programmer to set parameters, tailored to each individual’s unique symptoms, into the neurostimulator. The DBS settings are gradually tweaked over time and medications are simultaneously adjusted. Most people are able to decrease (but not completely discontinue) Parkinson’s drugs after DBS. Determining the optimal combination of drugs and DBS settings — that which gives the most benefit and the least side effects — can take several months and even up to a year.

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