Deep Brain Stimulation (DBS)
Deep brain stimulation (DBS) 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), it consists of electrodes placed in the patient’s brain and a pulse generator or battery system implanted under the skin in the body.
How Does Deep Brain Stimulation Work?
Electrodes: Surgically placed in specific regions of the brain. These electrodes send electrical signals to regulate abnormal electrical activities in the brain.
Pulse Generator (Battery): This device, implanted under the skin in the chest or abdomen, sends electrical stimuli to the electrodes. The generator can be programmed externally and adjusted according to the patient’s needs.
Connection Wires: Thin wires connecting the electrodes to the generator pass under the skin within the body, providing the connection.
Applications of Deep Brain Stimulation
Parkinson’s Disease: Effective in controlling symptoms such as tremors, stiffness, 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: Can be used to control seizures in resistant epilepsy cases.
Deep Brain Stimulation Surgery
Deep brain stimulation surgery is usually performed in two stages:
Placement of Electrodes: Electrodes are placed in the target region of the brain. During this stage, patients are usually awake so that surgeons can observe the patient’s movements to ensure correct placement of the electrodes.
Placement of the Pulse Generator: After the electrodes are placed, the pulse generator is implanted under general anesthesia in the chest or abdomen and connected to the electrodes.
Advantages and Risks
Advantages:
- Allows control of symptoms in patients who do not respond to drug therapy.
- Can reduce medication use and associated side effects.
- Improves quality of life.
Risks:
- Risk of infection
- Displacement or malfunction of the device
- Risk of bleeding or stroke in the brain (rare)
- Side effects: speech problems, balance issues, etc.
When used in the right patients and with the correct indications, deep brain stimulation is an effective treatment method that can significantly improve quality of life. Detailed evaluation and appropriate follow-up are important as the treatment process and outcomes can vary from patient to patient.
Frequently Asked Questions
Deep brain stimulation (DBS), also known as “neurostimulation,” is a medical procedure in which a device is implanted into the brain to target specific areas using electrical stimulation. The purpose of DBS is to alleviate or control symptoms of certain neurological disorders that cause involuntary movement disorders in the body.
Rest:
Ensuring adequate rest during the recovery period is crucial. Sleep can aid brain healing, and maintaining a proper sleep schedule can be beneficial.
Balanced Nutrition:
A healthy and balanced diet supports your recovery process. Follow the recommendations of your neurosurgeon or a dietitian to ensure you receive the necessary nutrients.
Regular Medication Use:
If you have post-operative medications, take them regularly as directed by your doctor.
Cognitive Exercises:
Brain tumor surgeries may affect cognitive functions. Mental exercises can support memory, thinking, and focus skills. Solving puzzles, reading books, or playing mental games can be helpful.
Doctor Check-Ups and Follow-Ups:
Regularly visit your doctor for check-ups and follow the guidance of your neurosurgeon to monitor the post-operative process and intervene if necessary.
Psychological Support:
Emotional and psychological challenges may arise after brain tumor surgeries. Psychologists or support groups can assist in this regard.
Support Systems:
Support from family, friends, and the community is critical during recovery. Seek help when needed.
Return to Work and School:
When returning to work or school, do so slowly and with your doctor’s approval. You may request a flexible work or school schedule.
Patient Evaluation:
The patient is carefully evaluated by a neurology specialist to determine which neurological disorder needs treatment and whether DBS is a suitable option.
Brain Examination:
Detailed imaging of the patient’s brain is obtained, usually through magnetic resonance imaging (MRI) or computed tomography (CT) scans, to identify the areas where the DBS device will be placed.
Surgical Planning:
Surgical planning for DBS implantation involves determining which brain regions the electrodes will be placed and where the device will be located.
Surgical Intervention:
DBS surgery is typically performed under local or general anesthesia. The patient may remain awake (which can help with the accurate positioning of the electrodes). Before starting the surgery, an incision is made on the skin to access the area where the DBS device will be implanted. Electrodes are placed in the brain regions to which the DBS device will be connected. Proper positioning of the electrodes is crucial. The DBS device is then placed under the skin or in another suitable location to control the electrodes and transmit appropriate electrical stimulation to the brain. This helps the nerve cells, whose electrical activity has been disrupted due to the disease, to regain normal function, thereby alleviating the symptoms of the disease. The settings of the DBS device are personalized based on the patient’s symptoms and responses and are periodically adjusted by a specialist. After surgery, the incisions are sutured, and the patient’s recovery is monitored.
Particularly for patients with Parkinson’s disease and tremors, symptoms such as tremors, inability to walk, and speech difficulties can be alleviated within a short period, allowing them to return to normal life.
The battery life of the implanted device is approximately 5-6 years. At the end of this period, the battery can be replaced with a new one in a 15-minute procedure without interfering with the brain wires.
