How Brain Pacemakers Treat Parkinson’s Disease
A brain pacemaker is a medical device implanted into the brain to stimulate the nervous tissues with electric signals. These pacemakers are being used widely to provide treatment to the patients having neurological disorders such as Parkinson's disease, epilepsy, and others. Other than giving stimulation to the brain, pacemakers also play an essential role in stimulating the spinal cord. Brain pacemakers have been found to offer a safe and effective procedure that provides symptomatic relief to patients.
Doctors know that deep brain stimulation works as a therapy for Parkinson’s disease. But they’re still trying to figure out why and how. A new study sheds some light on the mechanism of action, suggesting that DBS disrupts a pattern of excessively synchronized activity in the brain.
Download PDF Brochure of Study Here
Illustration: Alfred Pasieka/Science Photo Library/Corbis
In DBS, an implanted device sends tiny jolts of electricity through neurons, acting somewhat like a brain pacemaker. The technique is widely accepted as a treatment for Parkinson’s and other movement disorders; more than 100,000 patients have received implants that help control their tremors, rigidity, and other kinetic symptoms.
The research on Parkinson’s won’t just add to our stockpile of knowledge about the brain’s workings, it may also lead directly to the next generation of DBS devices. Experts in many neurological disorders (including epilepsy and chronic pain) are working on closed-loop systems, where an implanted device records signals from the body, and modulates its stimulation according to the patient’s need.
De Hemptinne explains that this phase-amplitude coupling, or PAC, is a normal feature of a healthy brain; it’s the excessive degree of synchronicity that poses a problem in the Parkinson’s brain. “In a healthy brain, the PAC is present when you’re not moving; then when you want to initiate a movement that PAC is strongly decreased,” she says. The neurons have to fall out of lockstep so some of them can engage in a new task. “But in Parkinson’s patients,” she says, “the neurons that are supposed to engage in the new task cannot, because they are still synchronized. So you have the difficulty with movement, the slowness, the rigidity.”
The surgery is most commonly performed as an asleep-awake-asleep procedure. The patient is asleep and anesthetized at the start of the procedure and awakened after the brain is exposed so he or she can respond to verbal commands with feedback that assists the surgical team in optimal placement of the electrodes. Afterward, the patient is put to sleep again as the final stage of the operation is completed. Since there are no pain receptors within the brain, patients experience no discomfort while awake during the operation.
References:
https://spectrum.ieee.org/the-human-os/biomedical/devices/how-brain-pacemakers-treat-parkinsons-disease
https://www.uclahealth.org/vitalsigns/brain-pacemaker-has-proven-benefits-for-patients-with-some-movement-disorders
https://www.theinsightpartners.com/reports/brain-pacemakers-market