Deep
brain stimulation (DBS) is a surgical treatment which is used to treat
some of the treatment-resistant movement and affective disorders such as
chronic pain, Parkinson's disease, tremor and dystonia. DBS surgery
involves the implantation of a medical device or implant that sends
electrical impulses to specific parts of the brain. The medical device
is called as brain pacemaker. Even though deep brain stimulation is used
to treat a variety of disabling neurological disorders, it is most
commonly used to treat the debilitating symptoms of Parkinson's disease
(PD), such as tremor, rigidity, stiffness, slowed movement and walking
problems.
Deep
Brain Stimulation is used mainly for patients who are suffering from
Parkinson's disease and whose symptoms cannot be adequately controlled
with medications.Parkinson's disease which is caused by degeneration of
brain cells that make a chemical called dopamine, is a common disorder
affecting nearly three out of one hundred persons over the age of 65
years. Nowadays Parkinson's disease is becoming increasingly diagnosed
in younger persons under the age of 50 years. As mentioned earlier in
Parkinson's disease thebrain cells degenerate. When these brain cells
degenerate the patient runs out of dopamine and develops slowing of
movement, difficulty with speech, slowed and shuffling walking and
tremor. In many patients Parkinson's disease goes undiagnosed since it
is often very difficult to diagnose and there is also lack of awareness
among people.
Before Deep Brain Stimulation Surgery
The
pre-surgery evaluation for Deep Brain Stimulation starts with a physical
examination of the patient by the treating doctor. After the physical
examination the doctor may prescribe imaging tests in order to locate
the specific region of the brain that causes tremors and symptoms of
movement disorder.One way to locate the target areas is to rely only on a
computed tomography (CT) or magnetic resonance imaging (MRI) scan.
While some surgeons stop there, others use an electrode recording
technique to map and target the specific areas that they will need to
reach. The patient will typically undergo tests like blood test,
electrocardiogram, chest X-ray etc. before the surgery.
How Deep Brain Stimulation surgery works?
The brain cells function by electrically encoding, processing and
transmitting information. Deep brain stimulation affects the electrical
functions of neurons, but the mechanism by which it alters those
functions, are unknown. According to some hypothesis, the reduction of
the effects of an abnormal neuronal activity occurs because of
inhibition, depolarization blockade or the adjustment of neuronal
activity to a constant rate. - Inhibition: The depolarization of axons terminating in target structure by deep brain stimulation causes these terminals to discharge and release neurotransmitters. Deep Brain Stimulation may cause a flood of inhibitory neurotransmitters that effectively shuts down neurons in thetarget structures.
- Depolarization blockade: If a neuron is constantly depolarized but below the threshold need to produce an action potential, the threshold for producing an action potential increases. Consequently, neurons find it more difficult to fire because the threshold increases.
- Altering erratic neuronal activity: Deep Brain Stimulation alters the abnormal discharge activity that results from the disease. It has been suggested that irregular or chaotic firing of neurons may be more disruptive of normal function than a constant and regular pattern of activity. It is possible that Deep Brain Stimulation drives the abnormally discharging neurons into a pattern of more regular firing that is less deleterious.
Deep brain stimulation is most commonly used to treat the symptoms of these common neurological conditions:
- Parkinson’s disease Deep brain stimulation was approved by the Food and Drug Administration (FDA) to treat Parkinson’s disease in 2002 and is now a standard treatment for this condition. Over time, the symptoms associated with Parkinson’s, which include stiffness, slowness, and tremor, become resistant to the medication. The symptoms will fluctuate as the medications provide relief for only a few hours at a time. For these patients, deep brain stimulation can offer steady symptom control for 24 hours per day, to provide better quality of life.
- Essential Tremor When patients have inadequate response to medication, deep brain stimulation is an option to effectively treat essential tremor. Research shows that medications often only elicits a response in about half of patients with essential tremor. However, patients who undergo deep brain stimulation can experience approximately 80 percent improvement in hand tremor.
- Dystonia Dystonia is a condition in which patients experience involuntary muscle contractions that force parts of the body into abnormal postures. DBS has been FDA approved for this condition under what is known as the Humanitarian Device Exemption (HDE.) This means that DBS surgery can be done on those with debilitating dystonia that does not respond well to medication, and in whom dystonia is the only neurological condition.
- Obsessive Compulsive Disorder (OCD) Deep brain stimulation has been approved by the FDA under the Humanitarian Device Exemption (HDE) for the treatment of obsessive compulsive disorder (OCD.)
What are the advantages of Deep Brain Stimulation?
The
device is programmable and hence the electrical stimulation is
adjustable.This is a great advantage since as the patient's response to
surgery changes over time, the stimulation can be adjusted without the
necessity of repeat surgery. Moreover the patient can also go for future
therapies like the brain cell transplantation since DBS surgery is not a
destructive surgery and the stimulator could be turned off. This may be
of great help to patients with Parkinson's disease.
It
has to be noted that a Deep Brain Stimulation Surgery is not suitable
for everyone and is not a cure for Parkinson's symptoms. A successful
Deep brain stimulation surgery may help patients to manage symptoms of
health conditions such as Parkinson's disease, Tremor and Dystonia and
lead a better quality of life. The extent of benefits and the time
duration required may vary from patient to patient. However it is seen
that many patients have experienced some benefits which has helped them
to lead a better quality of life. Some of such benefits are symptom
relief, the need for lesser medications, fewer side effects and the
patient may be able to resume normal activities.
About
My Med Opinion
MyMedOpinion.com provides the link
or bridge to the patient from their home country and destination country. They take care
of logistics and, in many ways, peace of mind. We provide step by step guidance
to international patients traveling to India so that they can avail quality and
affordable healthcare services at world-class hospitals without any waiting time.
We walk with you every step of the way, as we deliver the very best available
Medical care, meeting the highest international standards.
Send us a Medical Report to Get FREE Medical Opinion from India's Top Doctors
MyMedOpinion.com
is the hub of Surgeons and specialists for major diseases. We give you a
chance to speak to our doctors and discuss your health issues directly.
Email
Us: Free@mymedopinion.com Call Us: +91-7503537224
No comments:
Post a Comment