All you need to know about Deep Brain Stimulation

Neurological conditions often prove to be debilitating as these can interfere with the normal conduction of electrical signals between the brain and the body. This can lead to physical or mental impairment that can dramatically impact the quality of the patient’s life. Deep brain stimulation or DBS is a procedure that can help such patients lead better and more meaningful life. Continue reading if you want to know more about this phenomenal procedure and how it can help you. 

What is Deep Brain Stimulation or DBS?

Deep Brain Stimulation is a highly advanced procedure that aims at restoring the conductivity of electrical signals between the brain and the body by using artificially generated impulses. It involves the implantation of tiny electrodes in certain areas of the brain, to ensure healthy regulation of signals. As the name suggests, the procedure stimulates the brain to work as it should. 

Who are the candidates for Deep Brain Stimulation?

Deep brain stimulation can be used in treating a wide spectrum of neurological conditions, movement disorders and neuropsychiatric conditions. Some of the most common of these include:

Parkinson's Disease - 

It is a progressive neurodegenerative disorder marked by uncontrolled movement and shaking. It usually affects dopamine-producing neurons. The condition is mostly seen in adults above 60 years of age. It is characterized by symptoms like:

• Tremors in the limbs, head, and jaw. 
• Unusual stiffness in the muscles
• Slowed down movements
• Impairments related to balance and coordination
• Unexplained emotional changes and depression
• Problems related to urination 
• Feeling constipated
• Problems related to swallowing and chewing food
• Speech difficulties 

Essential Tremor - 

It is a neurological disorder that leads to uncontrollable rhythmic shaking of the body. The tremors become more evident when you are performing simple tasks like tying shoelaces or holding a cup of tea. It is characterized by symptoms like:

• Tremors, especially in hands 
• Inability to use certain tools 
• Quivering voice
• Involuntary nodding of the head 
• Tremors in the lower limbs

Dystonia - 

It is a movement disorder characterized by repetitive, twisting movements of different parts of the body due to involuntary muscle contractions. A person suffering from the condition is likely to present with the following symptoms. 

• Involuntary muscle contraction
• Muscle contraction due to stress and anxiety
• Eyelid twitching
• Torticollis
• Twisting movements
• Voicebox spasms
• Muscular cramps

Obsessive-Compulsive Disorder - 

The condition is marked by unreasonable fear or obsession with certain activities, objects or thoughts that compel the patient to indulge in repetitive behaviors. Some of the common symptoms that may be presented by a person with OCD include:

• Compulsive counting
• Excessive cleaning
• Washing hands more than usual
• Germophobia
• Aggressive thoughts
• Unnecessary need for cleaning
• Checking things repeatedly
• A constant need to keep things symmetrical
• A constant need to keep things in perfect order
• Getting anxiety if things are not placed in a particular order

Epilepsy - 

It is a neurological disorder characterized by frequent seizures. It involves the central nervous system and is triggered by some abnormality in the patient’s brain activity. Common symptoms that may suggest that a person has epilepsy include:

• Staring spell
• Loss of consciousness
• Confusion
• Fear
• Anxiety
• Uncontrollable movements of arms or legs
• Seizures
• Amnesia
• Muscle spasms
• Stiffening of muscles

Also, according to various researchers, deep brain stimulation can also work as an effective treatment for other conditions such as

• Anxiety
• Seizures
• Addictions
• Schizophrenia
• Eating disorders
• Chronic pain
• Depression
• Cluster Headaches
• Alzheimer's disease 
• Chorea
• Tourette syndrome

How does Deep Brain Stimulation work?

The DBS consists of four parts that include insulated wires which are also known as leads or electrodes that are placed in the brain. The anchors are used to fix the leads to the skull and a neurotransmitter is used to put out the electric current. The simulator is just like a heart pacemaker and it is usually placed under the skin below the collarbone. Further, in some cases, a thin insulated wire called an extension is added in order to connect the lead to the neurostimulator.

How is it done?

Firstly, the neurosurgeon uses MRI or CT scan to map the brain and identify the area in the brain where they can place the electrodes for DBS. 
Then an expert anaesthesiologist provides local anesthesia to numb the scalp before the procedure or provides general anesthesia so that the patient is asleep during the procedure. 

After that, the surgeon implants thin lead or electrodes in the specific areas of the brain that are identified beforehand. The electrodes are connected to a wire that runs under the skin to the stimulator that is implanted near the collarbone. The entire procedure is very crucial and requires absolute precision.

The pulse generator is programmed to send electrical signals continuously to the brain. The Intensity of the impulse can be controlled by the generator and it can be turned on and off with the help of a remote control when required. The doctor usually advises the patient to switch off the remote while sleeping and switch it on in the morning when you wake up. 

What to expect after the Surgery?

Deep Brain Stimulation surgery does not cure the disease completely but it helps to reduce the symptoms and improves the quality of life significantly. After the surgery, the pulse generator implanted in the chest is activated by the doctor which can control the special remote. You can also turn your stimulation on and off based on the recommendation of the doctor. Also, you may be required to visit the doctor regularly in order to see the progress of the treatment and the efficacy of the device.

By -Dr Aaksha Shukla | March 14, 2023 | 9 Min Read