Deep Brain Stimulation

Deep Brain Stimulation (DBS) is an advanced neurosurgical procedure used to treat a variety of debilitating neurological and psychiatric conditions.

Deep Brain Stimulation involves the implantation of a medical device called a neurostimulator, which sends electrical impulses to specific areas of the brain. These impulses regulate abnormal impulses, or affect certain cells and chemicals within the brain. The procedure is reversible and adjustable.

Mechanism of Action

Electrode Implantation: Thin electrodes are surgically implanted in specific areas of the brain, depending on the condition being treated.
Neurostimulator Placement: The neurostimulator (similar to a pacemaker) is implanted under the skin in the chest.
Control of Electrical Impulses: The neurostimulator sends controlled electrical impulses to the brain through the electrodes.
Adjustability: The intensity of the stimulation can be adjusted externally without additional surgery.

Conditions Treated

Parkinson's Disease

DBS helps reduce symptoms like tremor, stiffness, slowness of movement, and walking problems.

Essential Tremor

Effective in reducing tremors in hands or arms.

Dystonia

Alleviates involuntary muscle contractions.

Obsessive-Compulsive Disorder (OCD)

Can improve symptoms in severe, treatment-resistant OCD.

Epilepsy

Reduces the frequency and intensity of seizures.

Tourette Syndrome

Helps in managing severe tics.

Major Depression

Used for treatment-resistant depression.

Chronic Pain

Effective in certain types of intractable pain, like cluster headaches and neuropathic pain.

Chronic Pain

Research is ongoing for its use in conditions like dementia (Alzheimer’s disease), addiction, and anorexia nervosa.

The Procedure

Pre-surgical Assessment: Involves careful selection of candidates and detailed brain imaging.
Surgical Procedure: Performed under local or general anaesthesia. Electrodes are placed in the brain, and the neurostimulator is implanted in the chest.
Post-surgical Adjustment: Settings of the neurostimulator are adjusted over several sessions to optimise symptom control.

Risks and Side Effects

Surgical Risks: Include infection, haemorrhage, stroke, and hardware-related complications.
Side Effects: May include speech problems, muscle tightness, balance issues, and mood changes.

Benefits

Symptom Control: Effective in reducing symptoms of various neurological and psychiatric disorders.
Quality of Life: Can significantly improve the quality of life for patients with debilitating conditions.
Adjustability and Reversibility: Allows for personalised treatment and can be reversed if necessary.