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How is Deep Brain Stimulation (DBS) performed?
Deep Brain Stimulation (DBS) is a form of neurosurgical intervention for many neurological diseases, such as Parkinson’s disease, essential tremor, dystonia, and obsessive-compulsive disorder (OCD). It is performed by implanting a device that sends electric impulses to specific areas of the brain to regulate abnormal brain activity.
Steps in Deep Brain Stimulation (DBS) Procedure:
1. Pre-Operative Evaluation:
Patient Selection: Patients undergo detailed assessment before undergoing treatment with DBS to check if they will qualify for surgery or not. It usually consists of neurological and psychiatric assessments, imaging studies such as MRI or CT scans, and more invasive investigations in specific instances such as neuropsychologic tests or functional imaging (such as PET scans).
Target Area Mapping: In diseases such as Parkinson’s disease, DBS targets particular regions of the brain, i.e., subthalamic nucleus (STN) or globus pallidus interna (GPi). The exact target area is selected based on the symptoms of the patient and brain anatomy. Neuroimaging (MRI or CT scan) and stereotactic procedures occasionally are used to plan the surgery precisely.
2. Surgical Procedure
Anesthesia: The operation is usually done under local anesthesia, i.e., the patient is awake during the operation. This is required because the surgeon can ask the patient to provide feedback during the operation in order to ensure proper placement of the electrodes. Sometimes the patient is sedated but alert enough to provide commands.
Electrode Implantation
A small hole (usually 1 to 2 centimeters) is drilled into the skull to give access to the brain.
The physician then places a thin wire, an electrode, into the area of the brain (e.g., the subthalamic nucleus for Parkinson’s disease). This electrode will deliver electrical impulses to regulate abnormal brain activity.
As part of the process, microelectrode recording may be utilized to chart the brain activity and modify the positioning of the electrodes for maximum impact.
The patient may at some point be asked to execute motor movements or actions to assess the short-term efficacy of the stimulation.
3. Implantation of the Pulse Generator (Neurostimulator):
After the electrode is placed in its rightful location, another part of the DBS system, the pulse generator (also called the neurostimulator), is implanted under the skin, typically in the belly or chest. The device is connected to the electrode through thin wires beneath the skin.
The pulse generator sends electrical impulses to the electrode in the brain to change abnormal neural activity.
The location of the pulse generator is typically done in a second surgery, either immediately after the electrode has been implanted or during a follow-up visit.
4. Testing and Calibration:
After the electrode and pulse generator are implanted, the device is activated and subsequently programmed. The physician will also then modify the settings of the pulse generator so as to determine what the ideal stimulation parameters are, such as pulse rate, frequency, and intensity.
In some cases, the patients will be hospitalized for a short period after surgery for observation. The response of the patient to the stimulation will be monitored by the healthcare team and altered accordingly.
The surgeon or neurologist will ask the patient to carry out some tasks while the stimulation is being calibrated in order to measure the effectiveness of the stimulation, e.g., motor function or movement.
5. Post-Operative Care:
After the surgery, patients may need some time to recover. The follow-up appointments are scheduled to monitor the effectiveness of the DBS therapy and adjust the stimulation parameters if required.
Rehabilitation: Some patients may need physical therapy, speech therapy, or other rehabilitation to help them recover from the surgery and make the most out of DBS.
Patients are monitored for possible side effects, such as infection, bleeding, or inappropriately caused stimulation effects (e.g., mood changes or unwanted movement).
Programming and Adjustments:
The greatest thing about DBS is that the parameters of stimulation can be adjusted without surgery following surgery. Neurologists or other qualified medical staff use a special wand-like device to change the stimulation parameters to improve the patient’s symptoms or to adjust to any side effects.
The patient will need occasional changes during the course of time, especially if their condition shifts or if the device must be maximized.
Long-Term Maintenance:
The pulse generator’s battery usually lasts for a few years (depending on the programmer settings and utilization), and eventually, it will have to be replaced, typically by a minor surgery.
Follow-up appointments are required at intervals to monitor the function of the device, adjust the settings, and treat potential side effects.
Risks and Considerations:
Surgical Risks: Infection, bleeding, or damage to brain tissue are risks involved with any brain surgery.
Side Effects: DBS could be associated with side effects like dizziness, headache, mood swings, or temporary worsening of symptoms. In exceptional circumstances, DBS could be followed by cognitive complications or emotional changes, although the latter are usually controlled with fine-tuning of the stimulation parameters.
Long-Term Effects: Whether DBS will be effective in the long run and safe to use depends on how exactly the stimulation parameters are optimized and how the patient tolerates the treatment over time.
Conclusion:
Deep Brain Stimulation is a sophisticated and highly effective treatment for certain neurological diseases, especially Parkinson’s disease and essential tremor. Treatment involves the implantation of electrodes within the brain to regulate aberrant neural activity and reduce symptoms. While it can significantly improve quality of life in patients with severe symptoms, it requires careful planning, skilled performance, and ongoing adjustments to produce optimal results.
The Parkinson’s Protocol™ By Jodi KnappThus, the eBook, The Parkinson’s Protocol, educates you regarding the natural and simple ways to minimize the symptoms and delay the development of Parkinson’s effectively and quickly. It will also help your body to repair itself without following a specific diet plan, using costly ingredients or specific equipment. Its 60 days guarantee to return your money allows you to try for once without any risk