Deep Brain Stimulation (DBS) is a ray of hope in the world of neurological conditions. Think of it as a high-tech pacemaker for the brain; it can make a difference for people dealing with a variety of brain issues that have not responded to first-line treatments. In this article, we will explore what scientific research has to say about DBS, how it works, who it might help, and what we need to be careful about.
Deep Brain Stimulation involves sending small electrical signals to regions of the brain via electrodes connected to a neurostimulator implanted during two surgical procedures.
People living with neurological disorders associated with movement such Parkinson’s disease, essential tremor and dystonia can benefit from Deep Brain Stimulation.
Some evidence shows that Deep Brain Stimulation can help treat depression and obsessive-compulsive disorder.
While generally low-risk, surgery always carries some risk of complications.
What is deep brain stimulation?
Deep Brain Stimulation involves implanting electrodes in specific regions of the brain through tiny holes in the skull. These electrodes are connected to a neurostimulator that is usually implanted in the upper chest. The neurostimulator sends small electrical signals to the electrodes in the brain via tiny wires connecting the two. Electrical signals, carefully programmed and adjusted by a doctor to minimize side effects, are directed to the brain with the aim of regulating abnormal brain activity. Deep Brain Stimulators are sometimes called "brain pacemakers" due to their similar mechanism to heart pacemakers, which send electrical signals to regulate the heart's rhythm and maintain a normal heartbeat.
The aim of DBS is to alleviate symptoms associated with neurological disorders. Deep Brain Stimulation has primarily been used to treat neurological movement disorders, such as Parkinson's disease, but in recent years scientists have discovered that DBS may also help with mood and memory issues.
What the research tells us
Researchers have been studying DBS closely since before its introduction to mainstream medicine in the 1980s. They've found that it may provide positive changes for people affected by different neurologic and psychiatric conditions. Imagine someone with Parkinson’s disease whose quality of life is affected by unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination. A scientific review shows that DBS could improve their motor function and the self-reported quality of life.
It doesn’t stop there; systematic reviews (research papers that synthesize the evidence from all published clinical trials in a particular area) from recent years report the beneficial use of DBS for the treatment of essential tremor, obsessive-compulsive disorder (OCD), treatment-resistant depression, and epilepsy. However, scientists recommend that further studies be conducted to validate these promising results.
Parkinson's disease management
One of the most well-known uses of DBS is in the management of Parkinson's disease. A recent systematic review looked at all published clinical trials comparing DBS to the best medical therapy. Overall, these 8 trials show that DBS can reduce the motor symptoms of Parkinson's disease such as tremors, rigidity, and bradykinesia (slowness of movement), thus, offering an alternative when medication alone is ineffective or causes adverse side effects.
Treatment for essential tremor
Essential tremor, a condition characterized by uncontrollable shaking, can be very debilitating. Deep Brain Stimulation has emerged as an effective treatment option, with studies highlighting its ability to reduce tremors and improve the quality of life for affected individuals.
Potential for depression and obsessive-compulsive disorder (OCD)
Recent research has also explored the potential of DBS for treating psychiatric disorders. Studies suggest that stimulating certain brain regions may have a positive impact on individuals with treatment-resistant depression and OCD.
Although in its infancy, DBS as a treatment for refractory OCD has also shown promising results in reducing the time a patient spends occupied by obsessive thoughts and how much those thoughts interfere with their daily living. However, more research is needed in this area as well.
Deep Brain Stimulation has shown promise in regulating epilepsy, particularly in cases where traditional treatments have failed. Modulating abnormal brain activity can reduce the frequency and severity of seizures, but this too is a relatively new area of research and further studies are required.
What we need to watch out for
While DBS could be a superhero, it also has some kryptonite. Research has shown that it might affect how people think, especially for those with mental health issues. Thus, the use of DBS requires doctors to make sure there are no contraindications for the use of DBS before going ahead with the procedure.
In addition, the procedure involves one or two surgeries to implant electrodes, wires, and a neurostimulator in the patient. Just like any surgery, this presents some risks, such as the chance of developing an infection or the need for follow-up surgeries. Scientists are working hard to make it safer by improving surgical procedures but the risks still remain an important consideration before deciding to pursue DBS as a treatment.
The road ahead
As scientists continue to study DBS, they're finding new and exciting use cases for this technology. By investigating different parts of the brain, they are figuring out how to tailor DBS treatments to specific regions and needs. Companies making the DBS equipment are also helping, acting as tech wizards and creating powerful tools for doctors and scientists around the world.
As it stands, DBS provides another avenue of treatment for those with severe cases of the above-mentioned conditions. It's also a reminder that we need to be careful, make wise choices, and continue to learn from the ongoing scientific investigations. The future holds exciting possibilities for DBS, and it could make life a lot brighter for those living with a variety of brain conditions.
- Brain Stimulation. Clinical trials for deep brain stimulation: Current state of affairs.
- Cureus. Efficacy and Safety of Deep Brain Stimulation in the Treatment of Parkinson’s Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
- Nature - Molecular Psychiatry. Deep brain stimulation for refractory obsessive-compulsive disorder (OCD): emerging or established therapy?