Deep Brain Stimulation (DBS)
Deep Brain Stimulation (or DBS) involves the implantation of electrodes within the brain that generate electrical impulses within the brain, regulating the abnormal impulses. These generated electrical impulses can affect the particular cells and chemicals in the brain to help in concerning medical conditions. A pacemaker-like digital device placed under the skin in your upper chest controls the amount of stimulation in DBS (Deep Brain Stimulation). A thin wire moves under the skin and connects the device to the electrodes fitted surgically in your brain.
Why is DBS done?
DBS treats conditions which hamper the functioning of your neurons. Depending on the severity of the issue, the brain can partially or completely lose its ability to function properly. Here are some of the conditions where DBS is performed:
- Parkinson’s disease
- Essential tremor
- Obsessive Compulsive Disorder (OCD)
Who needs DBS?
Deep Brain Stimulation requires a close correlation between neurologists and neurosurgeons because of the multidisciplinary activities followed at the Apollo Hospitals, Karnataka, for effective results. It is done in a specially-trained clinic setting to safely & precisely identify the right candidate for DBS.
The benefits of this surgery are the improvement in the Motor symptoms of PD (Progressive Disorder), which results in improving the quality of life along with the reduction in the drug’s doses and their side effects. The patient who undergoes the DBS suffers from the progressive disorder and is still dopamine responsive but not able to take enough doses due to side effects. Patients with significant Psychiatric Symptoms need to be treated further and sometimes may be excluded. Previously, DBS was reserved for patients with the developed progressive disorder, but new trials have shown its benefits in early progressive disorder as well.
How do you prepare for the DBS procedure?
Pros and cons: Our board-certified team of doctors at Apollo Hospitals will carefully weigh the risks and benefits of Deep Brain Stimulation. They will discuss the pros and cons of this surgery since it is a risky procedure. They will examine you closely and discuss with you the risks involved and if you are eligible for this surgery.
Tests: If you decide to go for the surgery, you will need to get detailed MRI (Magnetic Resonance Imaging) and CT (Computer Tomography) scans of your brain. These scans will help your doctor to decide which location is ideal for placing the wires for the DBS.
Medications: The doctor will ask you to discontinue some medications since they might interfere with the procedure. It is mandatory for you to give detailed information about all the medicines and supplements that you are taking.
Grooming: The doctors and staff will direct you on how to bathe and prepare for the DBS procedure. This includes a specific kind of shampoo that prepares your skin for the DBS.
Fasting: You might be asked to fast before the procedure. You should not consume solid food eight hours prior to your surgery and liquid food two hours prior to the surgery.
What happens during the procedure?
In general, this is the flow of the Deep Brain Procedure:
The medical team will fit a head frame to keep your head fixed during the procedure. Then, the team members will perform neuroimaging tests to identify the area where electrodes will be implanted. To test the effects of the stimulation fully, you will be awake and conscious while electrodes are being placed.
You might be given local anaesthesia to numb your scalp before the procedure, but since your brain does not contain any pain receptors, you will not be kept under anaesthesia until it is necessary. A thin wire lead with a number of electrodes will be implanted into the specified area. A wire will run under your skin and will connect to a pulse generator which is implanted near your collarbone. Both the neurologist and the surgeons will closely monitor your brain to ensure that the electrodes are placed correctly.
Brain Wall Surgery: In the second part of DBS surgery, the surgeon implants the part of the device containing the pulse generator under the skin of your chest near your collarbone. You will be kept under general anaesthesia during this part of the procedure. Wires from the brain electrodes are guided down to the pulse generator under your skin. The generator continuously sends electrical pulses to the brain. You can control the pulse generator with a remote.
What are the risks involved in DBS?
Due to surgery involved in DBS, there are some possible risks and complications.
- Internal Bleeding or at the site of incisions
- Infections & Sepsis
- Swelling in and near the brain.
The procedures performed at Apollo Hospitals, Karnataka, are highly optimized and planned under the supervision of the expert team of medical professionals to eliminate the chances of any risks or complications.
Because of the pulse generator, there may be some complications or risks that can happen, including-
- 1. Failure of the pulse generator or leads
- 2. The Leads wire becomes loose
- 3. Incorrect displacement of the leads
- 4. Soreness near the pulse generator.
Though deep brain stimulation will not cure your disease, it definitely reduces your symptoms and enhances the quality of your life. In some cases, medications will still be needed after the surgery for better results.
Remember that Deep Brain Stimulation is not ideal for everyone. There are many factors that decide if it is right for you. The doctors at Apollo Hospital, Karnataka, will assist you and evaluate your symptoms thoroughly to help you decide if you can opt for this procedure.