Deep Brain Stimulation
Deep brain stimulation (DBS) is a procedure to treat neurological and mental conditions using a device that produces electrical impulses in the brain
What Is Deep Brain Stimulation (DBS)?
Deep brain stimulation is a surgical procedure requiring the implantation of electrodes into areas of the brain. The electrodes provide an electrical current that stimulate areas of the brain associated with severe health conditions. 1
DBS treats neurological disorders related to movement problems caused by faulty electrical signals in the brain. Some examples of neurological diseases treated with the use of DBS include:
- Parkinson’s Disease
- An essential tremor
- Multiple sclerosis
Deep brain stimulation can also help with certain mental health disorders, such as obsessive-compulsive disorder.
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How Common Are DBS Implantation Procedures?
There have been estimates that as of 2019, 160,000 people have received DBS implantation since the 1980s. Reports estimate that an additional 12,000 people receive this treatment each year. 2
Those most in need of this procedure are people who experience uncontrollable tremors, as medication tends to have little to no effect on these individuals. Deep brain stimulation procedures have also been used in the treatment of psychiatric conditions as well. 3
What Conditions and Symptoms Can DBS Treat?
DBS can treat a variety of both neurological and mental health conditions. Conditions where this treatment has been an effective form of treatment include:
Neurological Conditions
Some common examples of neurological conditions that DBS can treat include:
- Dystonia: Dystonia is when the body has involuntary muscle contractions that cause slow, repetitive movements and unusual postures. DBS can treat these symptoms by sending controlled electricity into the connected areas of the brain. 4
- Essential tremor: An essential tremor is a neurological condition that causes involuntary shaking. These most often occur in the hands and can extend to the legs. It may also cause movement of the head. The DBS procedure is the most common type of surgery for treating an essential tremor. 5
- Medication-resistant epilepsy: Using DBS therapy can help decrease the frequency of seizures for those with medication-resistant epilepsy. 6
- Parkinson’s disease: DBS therapy helps address the movement symptoms of Parkinson’s disease and the side effects caused by medication.
Psychiatric Conditions
More evidence is arising to show positive effects of DBS on severe mental health conditions such as: 7
- Medication-resistant obsessive-compulsive disorder (OCD): Deep brain stimulation can treat disorders like medication-resistant OCD by targeting specific areas of the brain involved in OCD.
- Addictions: Drug seeking behavior may decrease with the use of DBS treatment. The procedure targets the reward areas of the brain.
- Alzheimer’s disease: Deep brain stimulation can be effective in reducing the inflammation in the brain to help treat Alzheimer’s disease.
- Other psychiatric conditions: Anxiety, eating disorders, and schizophrenia have also benefited from DBS treatment.
What Happens Before Deep Brain Stimulation?
It’s best to talk with your doctor before deciding to start DBS treatment. If your doctor decides it’s a good idea, they’ll then run diagnostic tests to make sure you’re physically and mentally ready for DBS. These can include brain scans, a physical exam, and a readiness assessment.8
You may need to stop taking or decrease any medications you are currently taking. This helps to determine symptoms while on and again when off the medication. You will need to wash your skin and hair before the surgery in order to kill bacteria and avoid infection. You will also need to fast the night before surgery; this includes no food, drink, or medication.9
What Happens During Deep Brain Stimulation?
During the implantation procedure, you will first get the lead implanted with the use of numbing medication. Then, you will receive a CT or MRI to determine the placement of the leads.
During the procedure, you will be awake to move certain parts of your body as the leads are being implanted. After placing the leads, the doctor will place the neurostimulator, done under anesthesia. They will insert the neurostimulator in a “pocket” under the outer layer of skin, usually under the collarbone, chest, or abdomen. Finally, the doctors will attach the neurostimulator to the leads.
10
Once attached to the leads, the neurostimulator will be programmed to deliver an electrical signal to the brain. The programming occurs over a few weeks’ time.
What Are the Advantages of Deep Brain Stimulation?
There are many benefits for the use of deep brain stimulation treatment. Important benefits for using DBS to treat severe neurological and psychiatric conditions are:
- DBS can offer a treatment option when medications are not working or helpful
- It can be a life-changing, or lifesaving, treatment
- It is adjustable to you and your needs
- It’s reversible and can be taken out at any time.
What Are the Risks of DBS?
As with any form of treatment or surgery, there may also be risks involved. The risks of treatment may include:
- Reactions to anesthesia
- Coma
- Bleeding in the brain
- Difficulty concentrating
- Confusion
- Leaking of cerebrospinal fluid; clear fluid found around the brain and spinal cord
- Infection
- Stroke
- Pain or swelling at the surgery site
- Movement of the electrode from the original location
- Allergic reaction to parts of the implanted device
Let your healthcare provider know immediately if you experience side effects or concerns. It is important to note that electronic devices are not likely to interfere with the DBS device.
What Is the Success Rate of Deep Brain Stimulation?
DBS is effective in treating and improving quality of life for those with symptoms from mental or neurological disorders. However, it does not entirely cure the disorders. The success rate varies depending on the condition or disease treated. For example, a study reported benefits in 90% of people with treatment resistant major depressive disorder and obsessive-compulsive disorder. 11
Since DBS treatment is not a cure for the disease or condition treated, you may need to continue taking medication. DBS can also sometimes be the most effective when used in combination with medication, but it’s best to speak to your doctor before continuing any medications while utilizing DBS.
Does Insurance Cover DBS?
Many insurance companies will cover DBS treatment if determined necessary by a doctor. However, it is important to contact your insurance company to find out more.
Get Help With Deep Brain Stimulation at Profound Treatment
Profound Treatment is a premier mental health and addiction treatment center. We’re focused on providing individualized and evidenced-based treatment programs because we understand that no two individuals are the same.
That’s why at Profound Treatment, we are learning and evaluating the latest treatment modalities that involve psychology, medicine, neuroscience, and alternative medicines. To learn more about DBS and how it may benefit you or a loved one, contact Profound Treatment today.
Resources
- 1https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Deep-Brain-Stimulation
- 2 https://my.clevelandclinic.org/health/treatments/21088-deep-brain-stimulation
- 3https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/deep-brain-stimulation
- 4https://www.ninds.nih.gov/dystonias-fact-sheet
- 5https://www.mayoclinic.org/diseases-conditions/essential-tremor/diagnosis-treatment/drc-20350539
- 6https://onlinelibrary.wiley.com/doi/full/10.1111/epi.13964
- 7https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329833/
- 8https://stanfordhealthcare.org/medical-treatments/d/deep-brain-stimulation/what-to-expect/before-surgery.html
- 9https://mayfieldclinic.com/pe-dbs.htm
- 10https://www.uhhospitals.org/services/neurology-and-neurosurgery-services/conditions-and-treatments/deep-brain-stimulation/what-is-dbs
- 11https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802517/
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