Brain Pace (Deep Brain Stimulation in Parkinson’s Disease)
Deep brain stimulation (DBS) is a neurosurgical procedure used to treat certain neurological conditions, including Parkinson’s disease. It involves the implantation of a neurostimulator device, often referred to as a “brain pacemaker,” to deliver electrical impulses to specific regions of the brain.
In the context of Parkinson’s disease, deep brain stimulation is primarily used to alleviate motor symptoms, such as tremors, rigidity, and bradykinesia (slowness of movement), that are not adequately controlled with medication. It is typically considered for individuals who have had Parkinson’s disease for several years and experience fluctuations in their response to medication or medication-related side effects.
The deep brain stimulation procedure typically involves the following steps:
- Preoperative assessment: Before the surgery, a comprehensive evaluation is conducted to determine if the individual is a suitable candidate for deep brain stimulation. This assessment includes a thorough medical history, neurological examination, and imaging studies (e.g., magnetic resonance imaging or computed tomography scans) to identify the optimal target for stimulation.
- Surgery: The surgical procedure is performed under local or general anesthesia. It involves placing one or more thin, insulated wires called electrodes into specific target areas of the brain, typically the subthalamic nucleus (STN) or globus pallidus internus (GPi). The electrodes are carefully guided into position using neuroimaging and intraoperative techniques.
- Neurostimulator implantation: Once the electrodes are in place, they are connected to an implanted pulse generator, also known as the neurostimulator or brain pacemaker. The neurostimulator is usually implanted in the chest or abdomen and is programmable to deliver electrical pulses at various frequencies, intensities, and durations.
- Programming and adjustment: After the surgery, the neurostimulator is programmed by a neurologist or neurophysiologist to optimize symptom control and minimize side effects. The stimulation parameters can be adjusted and fine-tuned based on the individual’s specific needs. Regular follow-up visits are necessary to monitor and adjust the stimulation settings as required.
Deep brain stimulation for Parkinson’s disease has been shown to effectively reduce motor symptoms and improve quality of life for many individuals. However, it is important to note that it is not a cure for Parkinson’s disease, and it does not address non-motor symptoms or underlying disease progression.
As with any surgical procedure, deep brain stimulation carries risks and potential complications, including infection, bleeding, hardware-related issues, and side effects related to stimulation. It is crucial to have a thorough discussion with a neurologist and neurosurgeon experienced in deep brain stimulation to understand the potential benefits, risks, and expectations associated with the procedure.
Regular long-term follow-up care is necessary after deep brain stimulation, including ongoing monitoring of symptoms, adjustment of stimulation settings, and management of any device-related issues.