Deep brain stimulation (DBS) is a surgical technique in which an electrode (an uninsulated wire) is placed in the subcortical structures (below the surface) of the brain by the neurosurgeon in Delhi. This electrode connects to a stimulator (a battery), usually placed near the clavicle.
Technique
Deep brain stimulation requires the precise location of an affected area specificity of the brain using stereotactic imaging techniques(three-dimensional) with radiography, computed tomography, CT) or magnetic resonance imaging (MRI). After opening a small hole in the skull with a drill, special equipment allows placement image-guided accurate electrode in the affected part of the brain. During surgery, tests can be done to ensure the electrode will stimulate only neurons (nerve cells) that reduce symptoms. Every neurological disease has specific affected neurons. For example, in Parkinson’s disease, these are found in the subthalamic nucleus or the pale globe (brain regions); at hereditary tremor or epilepsy, the neurons of the thalamus (another region of the brain). Dice that the most effective intensity and frequency of electrical stimulation vary between diseases and patients after electrode placement tests are performed to choose the appropriate stimulation setting. Although it is not clear how DBS works, the most plausible explanation is that it reconnects brain circuits and leads to a better balance between the brain’s pathways of inhibition and excitation.
Indications
The use of DBS has been limited to severe forms of the disease that have not responded to regular medical treatment. India approved the use of DBS in Parkinson’s disease, hereditary tremor (uncontrollable hand tremor) and dystonia(uncontrollable body movements). Its use is being studied to
- the depression;
- epilepsy;
- obsessive disorder compulsive (obsessive-compulsive disorder, OCD);
- disorders of feeding;
- cluster headaches (a type of headache extremely intense);
- chronic pain;
- Tourette’s syndrome(uncontrollable tics in the face and limbs);
- post-traumatic coma
Risks
Since DBS is an invasive procedure, serious complications can occur; among others, bleeding and infection, pathological scarring and accident cerebrovascular Some other complications can be headaches, problems neuropsychiatric (mood swings, apathy, hallucinations), and rupture of the cable, battery malfunction or electrode displacement. Because the battery has a limited lifespan, it must be replaced regularly by surgery.
Limitations
DBS is expensive and requires a long-term commitment from the patient, family, and the neurosurgeon in Delhi. It may have unknown long-term effects. Because DBS does not cure any disease, in general, only patients are considered for this treatment who have major disabilities and do not respond to medical treatment.