CHECK-UP:What is deep brain stimulation and how does it work, writes MARION KERR
My aunt, who lives in the States, has suffered from Parkinson’s disease for many years.
She had developed a very bad tremor and recently underwent something called DBS to treat it. She says this has worked very well and I’d like to know a bit more about the procedure. What is DBS?
Deep brain stimulation (DBS) is a means of inactivating a specific part of the brain, without destroying the brain itself.
The technology is not dissimilar to that used in a cardiac pacemaker. While a pacemaker is designed to maintain a certain cardiac rhythm, DBS helps control dysfunctional brain circuits allowing it to function more smoothly.
Small electrodes are placed in specific areas of the brain and connected by wires to a device known as an impulse generator (IPG). This generator is usually implanted under the skin just below the collar bone.
Once the device is switched on, it sends continuous electrical impulses to the electrode which blocks the brain impulses causing tremor and involuntary movements.
A magnet is then used with the IPG to adjust the stimulation strength enabling the appropriate level to be transmitted to the electrode placed in the brain.
Is it a very new procedure – I’d never heard of it before?
Deep brain stimulation has been used for the treatment of intractable pain for many years.
More recently, however, it has been used to treat tremor and involuntary movements associated with a range of conditions such as multiple sclerosis, Parkinson’s disease and dystonia.
Although it has been estimated that about 35,000 DBS procedures have been carried out worldwide, the first DBS was undertaken in the Republic at the Mater Private Hospital last year.
DBS is not a cure for neurological conditions, but is used to control particular symptoms. It is only ever considered when medication has been ineffective in adequate symptoms control.
My aunt says she was awake during the whole surgery – why was that?
Although it sounds like it should be painful, with local anaesthesia placed in sensitive areas, the procedure is indeed performed while the person is awake.
This is possible because the brain is unable to generate pain signals and therefore does not feel pain.
Because the person is awake throughout the surgery, it allows interaction with the surgical team and objective testing of brain function when various areas are stimulated.
Deep brain stimulation
Deep brain stimulation is a means of inactivating a specific part of the brain, without destroying the brain itself. It has been used for the treatment of intractable pain for years but more recently has been used to control tremor and involuntary