deep brain stimulation

Deep brain stimulation (DBS) is a technique involving the insertion of an electrode into particular areas of the brain and stimulating them with minute electrical currents from a special external pacemaker like device.  The 'deep' comes from the locations within the brain which are targeted; usually portions of the basal ganglia which lie towards the center of the brain. 

The stimulating electrical currents over ride abnormal signals being produced by injured or diseased nerve cells, thereby suppressing the symptoms the abnormal signals were causing which are most often abnormal movements.  Where as DBS is not a curative procedure, it can have a dramatic effect on symptoms and day to day function of the patient by reducing abnormal movements that h ANAer the subjects functioning.

Technique:

Careful positioning of the electrode is essential, and is achieved by three dimensional targeting with X-rays and by measuring the local electrical activity of the nerve cells through which the electrode passes. Each group of cells has it's own signature firing pattern which can be recognized and aid in localizing the the tip of the electrode within the brain.

Uses:

DBS is primarily used for the treatment of advanced Parkinson's Disease, particularly those who have disabling tremor. It has also been used for severe Essential tremor.

Upside:

• Non - destructive
• Can be modulated to the degree of symptoms present

Downside:

• suppressive therapy only
• Can be complicated by bleeding at the site of the electrode insertion
• requires leaving a foreign body within the brain and skull which has attendant risk of infection

Last Word on DBS:

DBS is an extremely useful tool for the treatment of Parkinson's Disease and especially tremor due to Parkinson's disease. It has been investigated but not approved for use in multiple other disorders.

On line Resources:

Medtronic (manufacturer of DBS equipment)

Parkinson's Disease Foundation