Deep brain stimulation (DBS)

Specialty of Neurology

What is deep brain stimulation?

Deep brain stimulation involves electrodes being implanted in certain areas of the brain to help people with a range of neurological disorders.
 

Why is deep brain stimulation performed?

Deep brain stimulation is a treatment for movement disorders and for people who are not able to have control over their symptoms with medications. DBS is used in order to treat the following neurological conditions:

• Tremors
• Parkinson’s disease
• Dystonia
• Epilepsy
• Tourette syndrome
• Chronic pain
• Obsessive-compulsive disorder


What is the procedure for implanting deep brain stimulation?

For the deep brain stimulation to be implanted means that there are to be two separate surgeries. Following an MRI scan to locate the appropriate place in the brain, surgery implants the electrodes in the brain. A stereostatic head frame is fixed to keep the patient’s head still during the procedure. Once the scalp has been numbed, the thin wire with electrodes is implanted into the brain and a neurostimulator is implanted near the collarbone. The patient is to be awake so that the neurologist and surgeon can ask questions, ensuring that the correct areas of the brain are being stimulated. A day later, the neurosurgeon implants a pulse stimulator in the chest of the patient in chest wall surgery. A small opening is made behind the ear and the extension wire is passed under the skin to connect to the neurostimulator. The stimulator is programmed to send electrical pulses to the brain.
 

How does the DBS system work?

A DBS system uses an implanted pulse generator, a lead (called an electrode) and an extension wire. The lead is implanted in the target region of the brain. The extension wire reaches under the skin and connects the lead to the implanted pulse generator, which then sends out the electrical signals. The deep brain stimulation changes brain activity and is associated with an increased release of an energy carrying module called adenosine triphosphate, which is found in the cells of all livings things. This release creates a build-up of adenosine, which once activated triggers a process that reduces both tremor and any adverse effects caused by DBS.
 

What are the risks associated with deep brain stimulation?

Stimulating the brain may cause side effects. As the surgery involves making small holes in the skull to implant electrodes, and surgery to implant a device that contains the batteries under the skin in the chest. The risks of surgery include bleeding on the brain, stroke, breathing problems, heart problems and seizures. Therefore, a patient should really consider whether this is a procedure that they want.
 

What are the benefits of deep brain stimulation?

The DBS implant helps ease symptoms in patients who suffer from illnesses such as Parkinson’s disease where medications fail to control their tremors. According to Medical News Today, results of a two-year clinical trial have found that DBS improves the overall quality of life and social functioning of patients in the earlier stages of Parkinson’s disease. DBS can also help with difficulty in walking and dystonia.

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