A study published in the Lancet Neurology states that 3.4 billion people suffer from neurological disorders, such as Parkinson’s disease, essential tremors, dystonia, epilepsy, etc., that cause slowness, stiffness, involuntary movements, and difficulty performing daily tasks. Some cases are so severe that even medications are not enough to control the symptoms of certain neurological conditions. In such cases, medical professionals usually turn to deep brain stimulation (DBS) as a viable treatment option for symptom relief.

Although DBS can’t entirely cure a neurological disorder, it can help significantly control the associated symptoms, allow patients to regain control over their own bodies and minds, and improve the quality of their lives. 

Read on to learn what deep brain stimulation actually is and how it can change the patients’ lives.

What is Deep Brain Stimulation?

Deep Brain Stimulation (DBS) is an established medical treatment for individuals with certain movement conditions such as tremors, dystonia, obsessive-compulsive disorder, epilepsy, Parkinson’s disease, and other mental disorders. This neurosurgical procedure involves implanting electrodes within specific areas of the brain. These electrodes send electrical impulses to affected areas in the brain, helping to regulate abnormal brain activity and treat certain neurological conditions.

Who Needs Deep Brain Stimulation?

DBS is usually used to treat medical conditions affecting how your neurons function. When your neurons fail to work properly, it could affect the abilities controlled by these neurons. A neurosurgeon might recommend you to undergo a deep brain stimulation operation when:

• Medications or other forms of treatment have proven to be inadequate or don’t work as quickly or effectively as they used to.
• The doses of medication are increasing but delivering the same effect.
• You have to take medications multiple times every day.
• Medications prescribed to control symptoms cause unacceptable side effects like dyskinesias, hallucinations, etc.
• The side effects of medications can’t be no longer tolerated.

How Does Deep Brain Stimulation Work?

A deep Brain Stimulation procedure is performed to deliver high-frequency electrical stimulation to the affected areas of the patient’s brain with half of modern state-of-the-art neuro imaging. First, a surgeon identifies the targeted areas within the brain according to the patient’s illness and related symptoms. For example, for essential tremors, the thalamus is the focal point, and in Parkinson's disease, the subthalamic nucleus or globus pallidus is typically targeted for dystonia. 

After identifying the targeted area, a thin wire with electrodes at the tip is implanted into the brain’s area, modulating the abnormal signals producing the symptoms. High-frequency stimulation produced by the electrodes alters these abnormal signals, helping improve the symptoms.  

Before this medical procedure, healthcare professionals usually perform a pre-operative evaluation to maximise the deep brain stimulation success rate. This evaluation generally includes a thorough neuro-radiological examination, an MRI scan of your brain, neuropsychological testing, evaluating the movement both on and off medication via video, and others if necessary.

MRI localisation and intraoperative microelectrode mapping play a vital role in the precise placement of the electrodes. After their placement, the electrodes’ wire is connected to the neurostimulator power supply, which is placed under the skin near the chest. This device, often known as a brain pacemaker, delivers finely tuned electrical impulses to influence the brain’s electrical activity and correct abnormal signalling patterns, helping to reduce symptoms such as tremors, rigidity, bradykinesia, or involuntary movements. 

How is Deep Brain Stimulation Changing Lives?

Deep brain stimulation can help treat several disorders affecting your brain, from movement disorders and mental health conditions to epilepsy, when medications fail to show effective results. Here’s how DBS is changing patients’ lives:

1. Helps Restore Independence for Parkinson’s Patients

Parkinson’s disease is found to be the second most common neurodegenerative condition that can severely impact a person’s nervous system and other body parts controlled by nerves. This disorder can affect one’s mental health, ability to perform even basic tasks, and sleep, and can cause pain, tremors, pain, and other health problems. With time, the symptoms of Parkinson’s disease can worsen and while there’s no cure, medicines and therapies can help reduce symptoms.

If the medications are no longer effective and the patient is the right candidate, undergoing a deep brain stimulation operation can be a life-altering event. But who is considered a good candidate? A patient who has had a Parkinson’s diagnosis for almost five years and is still responsive albrit to a laser magnitude to medical therapy can undergo DBS, although early station studies are forthcoming

Two electrode wires are placed into the brain are on each side, where they chronically and continuously provide electrical stimulation to treat the symptoms that patients experience, allowing them to reclaim their independence.

2.                   Enhances Quality of Life for Patients with Essential Tremor

Essential tremor is a neurological condition that can cause involuntary shaking, often affecting the hands, voice, or head. For those with severe essential tremors, daily activities like eating, writing, or speaking can be a challenge. Deep brain stimulation has been researched to provide moderate relief for around 90% of patients diagnosed with essential tremors.

During DBS surgery, electrodes are placed in your thalamus to treat essential tremors. These electrodes are connected by wires to a pacemaker, which sends continuous, painless electrical stimulations to the thalamus, which blocks the impulses that cause tremors. Thus, the associated symptoms will be reduced to a degree, allowing patients to live more comfortably and engage in activities they enjoy. 

4. Addresses Epilepsy

DBS is also showing promise in managing epilepsy and chronic pain. Many patients first try anti-seizure medicines to control seizures, but about 30%-40% of cases show no improvement. Another treatment is to undergo surgery to remove a small piece of the patient’s brain that causes seizures and chronic pain. 

A healthcare provider suggests deep brain stimulation as an option when the other epilepsy treatments fail to work & the epiletiform discharges are lbilateral.  Instead of destroying your brain tissue or causing the side effects of a surgery, such as language or memory problems, DBS will help reduce seizure frequency and severity by targeting areas like the anterior nucleus of the thalamus where your seizures start. 

5. Helps Treat Mental Health Conditions

While DBS has traditionally been associated with movement disorders, recent advancements suggest that it could be a promising treatment for certain mental health conditions, including obsessive-compulsive disorder (OCD) and depression. 

For instance, in cases of severe, treatment-resistant OCD, DBS has shown the potential to provide relief by targeting affected brain areas associated with obsessive thoughts and compulsive behaviours. The electrodes are usually placed in the VC/VS anterior limb to treat severe OCD.

3.                   Dystoria

 

Final Remark

The introduction of deep brain stimulation has made it possible to manage and control symptoms developed by certain neurological disorders that medications or other treatments can’t cure.

Want to learn more about DBS and how it can manage your neurological disorder? Wondering what the deep brain stimulation surgery cost is? Consult the top neurosurgeon at Medanta today!