Deep Brain Stimulation for Movement Disorders
Electricity Regulates Brain Circuitry, Reduces Involuntary Movement
Jul 22, 2009
Early attempts to address brain circuitry issues and the tremors they cause, involved lesioning, or burning away a small amount of brain tissue. While this method has proven effective in changing brain function, and is still used for certain disorders, it has the disadvantage of being permanent and irreversible.
Downsides of Medications
New medications developed between the 1930’s and the 1960’s reduced the need for lesioning procedures for many disorders, but carried their own set of downsides, including negative side effects (some, such as those used to treat Dystonia, even caused cognitive impairment) and a tendency to lose effectiveness over time.
In contrast, Deep Brain Stimulation (DBS), a type of functional neurostimulation administered by a Neurosurgeon, can be both removed and adjusted and has few negative side effects.
How Deep Brain Stimulation Works
DBS technology is similar in concept to a pacemaker for the heart. After testing to determine exact placement, an electrical lead is implanted in the effected area of the brain and is fixed in place. Two weeks after the wire is placed, the patient returns to the operating room. A device designed to emit an electrical impulse is implanted under the skin in the chest and is attached to the wire lead through the neck.
By sending an electrical impulse into the effected area of the brain, DBS can unscramble disordered brain circuitry, turning off the signals that mistakenly tell nerves to create muscle movement. The results are often comparable to successful lesioning surgery, but no brain tissue is destroyed.
The ability to fine tune that electrical signal from outside the body is one of the biggest advantages of DBS over other types of neurosurgical techniques. Using a palm-pilot sized device placed against the wall of the chest over the unit, the electrical field emitted by the wire lead can be widened, narrowed, or sculpted as needed to achieve the desired results. Many patients experience a dramatic reduction in unwanted movement within minutes of surgery.
Post surgical infection or hemorrhaging are the biggest risks of DBS. If infection occurs, or if treatment fails to show benefits, the device can be removed with no long term effects.
What Conditions Can DBS Treat?
Although DBS was originally developed as a way to treat pain by interrupting neural pathways in the brain, it was approved in the 1980’s by the FDA under the Humanitarian Device exception to treat movement disorders.
It is primarily being used today to treat essential tremor, Parkinson’s disease and Dystonia but is also being tested for use in Huntington’s chorea, Tourette’s syndrome, and other neurological disorders.
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