Brain Pacemaker: An Overview
A brain pacemaker is a medical device used in the treatment of neurological disorders such as Parkinson’s disease and other movement disorders. Technically known as “deep brain stimulation” (DBS), the brain pacemaker consists of electrodes implanted in the patient’s brain and a pulse generator or battery system placed under the skin in the body.
How Does a Brain Pacemaker Work?
- Electrodes: Surgically implanted in specific regions of the brain, these electrodes send electrical signals to regulate abnormal electrical activities in the brain.
- Pulse Generator: Placed under the skin in the chest or abdomen, this device sends electrical stimulations to the electrodes. The generator can be programmed externally and adjusted according to the patient’s needs.
- Connection Cables: Thin wires connecting the electrodes to the generator run under the skin, ensuring the connection.
Uses of a Brain Pacemaker
- Parkinson’s Disease: Effective in controlling symptoms such as tremors, rigidity, and slow movement.
- Dystonia: Controls muscle spasms and abnormal movements.
- Essential Tremor: Helps in controlling tremors.
- Obsessive-Compulsive Disorder (OCD): Can be used in some cases.
- Epilepsy: Helps control seizures in resistant epilepsy cases.
Brain Pacemaker Surgery
The surgery typically involves two stages:
- Electrode Placement: Electrodes are placed in the targeted brain region. Patients are usually awake during this stage so surgeons can observe their movements to ensure correct electrode placement.
- Pulse Generator Placement: After electrode placement, under general anesthesia, the pulse generator is placed in the chest or abdomen and connected to the electrodes.
Advantages and Risks
Advantages:
- Controls symptoms in patients unresponsive to medication.
- Reduces medication usage and associated side effects.
- Improves quality of life.
Risks:
- Infection risk.
- Device displacement or malfunction.
- Risk of brain bleeding or stroke (rare).
- Side effects: Speech problems, balance issues, etc.
When used for the right patients and indications, a brain pacemaker can significantly improve the quality of life. Detailed evaluation and proper follow-up are crucial as the treatment process and outcomes can vary from patient to patient.
Frequently Asked Questions
Medically termed “deep brain stimulation (DBS)” or “neurostimulation,” a brain pacemaker is a medical procedure in which a device is implanted in the brain to target specific areas with electrical stimulation. The purpose of a brain pacemaker is to alleviate or control symptoms of certain neurological disorders that cause involuntary movement disorders in the body.
Rest: Adequate rest is important during the recovery period. Sleep can aid brain recovery. Paying attention to your sleep schedule can help during this process.
Balanced Nutrition: A healthy and balanced diet supports your recovery process. You should follow the recommendations of your brain surgeon or a dietitian to get the necessary nutrients your body needs.
Regular Medication Use: If you have post-surgery medications, you should use them regularly as directed by your doctor.
Cognitive Exercises: Brain tumor surgeries can sometimes affect cognitive functions. Mental exercises can support your memory, thinking, and focus skills. Solving puzzles, reading books, or playing mental games can be beneficial.
Doctor Check-ups and Follow-ups: Regular doctor check-ups and following the guidance of your brain surgeon are important for monitoring your post-surgery process and intervening when necessary.
Psychological Support: Emotional and psychological challenges may arise after brain tumor surgeries. Psychologists or support groups can help with this.
Support Systems: Family, friends, and community support are critical during the recovery process. It is important to seek help when needed.
Returning to Work and School: When you want to return to work or school, you should do so with your doctor’s approval and gradually. You may request a flexible work or school schedule.
Patient Evaluation: The patient is carefully evaluated by a neurology specialist. It is determined which neurological disorder needs to be treated and whether a brain pacemaker is a suitable option.
Brain Examination: A detailed image of the patient’s brain is taken, usually with magnetic resonance imaging (MRI) or computed tomography (CT) scans. These examinations help determine the areas where the brain pacemaker will be placed.
Surgical Planning: Surgical planning is done for the implantation of the brain pacemaker. This includes determining which brain regions the electrodes will be placed in and where the device will be located.
Surgical Procedure: The brain pacemaker surgery is usually performed under local or general anesthesia. The patient may be awake (this can help with the correct positioning of the electrodes). Before starting the surgery, an incision is made on the skin, and the area where the brain pacemaker will be placed is reached. The electrodes are placed in the brain regions to which the brain pacemaker will be connected. Correct positioning of the electrodes is crucial. The device of the brain pacemaker is placed under the skin or in another suitable area. This device controls the electrodes and transmits appropriate electrical stimuli to the brain. Thus, the nerve cells whose electrical activity is disrupted due to the disease are regulated, and the symptoms of the disease disappear. The settings of the brain pacemaker are personalized according to the patient’s symptoms and responses. These adjustments are made periodically by a specialist. After the surgery, stitches are placed, and the patient’s recovery is monitored.
Patients, especially those with Parkinson’s and tremors, can quickly overcome difficulties such as tremors, inability to walk, and inability to speak and return to normal life in a short time. The lifespan of the implanted battery is about 5-6 years. At the end of this period, the old battery can be replaced with a new one in a 15-minute procedure without interfering with the wires in the brain.
