Discovering the Benefits of Deep Brain Stimulation (DBS)

Discovering the Benefits of Deep Brain Stimulation (DBS)

Deep Brain Stimulation (DBS) is a neurosurgical procedure that uses implanted electrodes and electrical stimulation for the treatment of movement disorders caused due to Parkinson's disease (PD), Dystonia, Essential tremor, and other neurological diseases.

In this elective surgical operation, electrodes are inserted into specific parts of the brain. These electrodes, often referred to as leads, generate electrical impulses that are utilised to control abnormal brain activity. The electrical impulses can also correct the chemical imbalances in the brain that lead to various illnesses. The stimulation of different areas of the brain is controlled by a programmable generator positioned just below the skin in the upper chest.

There are three different parts to the DBS system:

• The electrode, often known as the lead, is a tiny, insulated wire that is implanted into a specific part of the brain through a small incision in the skull.
• In order to link the electrode to the internal pulse generator (IPG), an extension wire that is also insulated and inserted under the skin of the head, neck, and shoulder is used.
• The third component of the system, the IPG, is typically implanted in the upper chest under the skin.

What are the benefits of Deep Brain Stimulation (DBS)?

There are many benefits of DBS. These consist of:

• Providing a treatment alternative when medicines aren't effective - When medications are ineffective or lose their beneficial effects, DBS is a possible option. Since Parkinson's disease treatments gradually lose their beneficial effects over time, your doctor may need to increase your dosage, which can have further adverse consequences and compliance issues and expenses. However, with DBS, fewer medication dosages can be effective again, resulting in better symptom control with fewer side effects.
• Life-changing or life-saving treatment – Certain Neurological issues that can cause severe adverse effects, make even the simplest of actions difficult, can be effectively controlled or treated with DBS. DBS can help manage these conditions and reduce symptoms, thus improving overall well-being.
• Adjustable - The pulse generator parameters can be adjusted by the neurologist/neurosurgeon to obtain the optimum/best response.
• Reversible - If DBS doesn't work or has adverse effects on the patient, a follow-up surgery can be used to remove the leads and pulse generator.
• Better quality of Life - Additionally, it could enhance your ability to carry out daily tasks such as dressing, getting out of a chair, and walking. As a result, both your freedom and quality of life will increase.
• Who is the candidate for Deep Brain Stimulation?

DBS is just not a mere surgical procedure. Patients in whom DBS is indicated, have to be mentally prepared for the entire preoperative evaluation, and multiple consultations to ascertain how much benefit can the patient get post-surgery, it also involves a series of evaluations to titrate the best optimum dose for the patient. These patients and their families thus have reasonable expectations and a clear understanding of the extent of benefits, hazards and success rates of the procedure. The expectations from the procedure should be realistic both for the doctor and also for the patient. Having said this DBS does have the potential to significantly enhance the quality of life for a select group of people and reduce Parkinson's disease-related movement symptoms, but it is unlikely to make anyone completely healthy again.

Right Candidates for DBS should fulfil the following requirements:

• Patients with uncontrolled tremors are not controlled by medicines.
• Despite taking the right amount of medicine, symptoms remain uncontrolled.
• Patients may benefit from taking higher or more frequent medication dosages but are constrained from doing so due to negative effects.
• Candidates with Essential Tremor or Dystonia, Parkinsons' Disease.
• Individuals who have Tourette syndrome, OCD, or depression.
• Diagnosis of Deep Brain Stimulation (DBS)

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Patients need multidisciplinary evaluation for treatment from a team of Neurologists, Neurosurgeons, and Psychiatrists. Testing of motor symptoms, both on and off medication, is frequently conducted on Parkinson's disease or tremor patients to determine the severity of the condition. Electroencephalography, along with more sophisticated testing, may be used in epilepsy diagnosis. During the examination, certain patients could undergo neuropsychological testing.

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Before DBS surgery, patients undergo the following tests:

• Blood and urine tests
• MRI and/or CT scans

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