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What is Deep Brain Stimulation?
Deep brain stimulation is a technique in which an electrode is placed directly into the brain. The electrode and battery are all implanted beneath the skin and are barely visible. The system delivers electricity to certain specific deep parts of the brain to help regulate movement and coordinate muscle movement.
Deep brain stimulation is also used to modulate pain. Electrodes are placed in deep structures of the brain and connected to a battery which deliver electricity to these areas to help reduce or eliminate pain.
Who needs deep brain stimulation?
Deep brain stimulation is used for treatment of movement disorders in which medications and other forms of treatment are no longer helpful. Examples of movement disorders are Parkinson’s disease and Essential tremor. in Parkinson’s disease specific brain cells are depleted of a neurotransmitter called dopamine. One of dopamine’s functions is to help coordinate movement. If the amount of dopamine falls below optimal levels, then muscular coordination can be disrupted. This can result in the following symptoms:
- Tremors: Uncontrolled shaking of the head, arms/hands, or legs
- Rigidity: Stiffness of the limbs
- Disturbed balance and coordination
- Slow movement including walking
- Limited facial animation
Identify & Locate
The surgical team identifies and locates the target desired to treat the movement disorder. This is done through magnetic resonance imaging (MRI) and computed tomography (CT) scans.
Target Area
The deep brain stimulation system has three components: (1) the electrode, (2) the extension, (3) the neurostimulator. A small hole is made in the skull and the electrode is placed into the brain. The tip of the electrode is placed within the target area which varies in location depending on the disease process.
Implant Extension
Next, the extension is implanted. This is a wire that connects the electrode and neurostimulator. It passes underneath the skin of patient’s head, neck and the shoulder.
Implant Neurostimulator
After this, the neurostimulator (battery) is implanted beneath the collarbone. However, it can also be implanted in the chest or beneath the skin of the abdomen. The neurostimulator is a battery that provides electrical charges to the electrode.
Symptomatic Improvement
Once all three components of the system are in place, the neurostimulator sends electrical impulses through the extension and electrode into the target area of the brain. These impulses modulate the cells of the target location improving the symptoms of Parkinson’s disease.
What happens after the deep brain stimulation procedure?
The patient will need to remain hospitalized for one or two days after the surgical procedure. Then, a few days following the procedure, the patient will have a follow-up visit with the surgeon so that they can examine the incision site. Typically, the surgeon will recommend the patient restrict themselves to light activity for a few weeks; most patients will be able to return to normal activities in approximately six to eight weeks. At about six weeks the neurostimulator programming begins with the help of the neurologists.
The deep brain stimulation system can significantly reduce the symptoms of Parkinson’s disease. The amount of reduction in symptoms varies from patient to patient but in most of the cases the reduction is significant.
Although the deep brain stimulation system reduces the symptoms, it does not remove them entirely. Therefore, patients still have to take medication (typically at a reduced dosage). The reduction in the dosage can then improve the side effects of the medication.
This material is intended to give the patient an overview of surgical procedures and treatments and is not intended to replace the advice and guidance of a physician. Always consult with your doctor about the particular risks and benefits of your treatment.
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