Deep Brain Stimulation: Brain Pacemakers

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Deep Brain StimulationBrain Pacemakers

• Kaitlin Abbate

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What is Deep Brain Stimulation (DBS)?

• Surgical treatment involving placement of brain
  pacemaker into the brain
• Sends electrical impulses to various places in
  the brain
• Changes the brain activity that was previously
  happening so it becomes more normal

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Components of the Pacemaker

• Implanted Pulse generator (IPG)
• Encased in titanium
• Sends impulses to area of brain to interfere with
  neural activity
• Generally placed near clavicle
• Extension
• Connects leads to IPG
• Runs from head, down neck, behind ear, and to IPG
  in chest
• Leads
• Coiled wire insulated in polyurethane with four
  platinum electrodes
• Lead to the specific targeted site of brain

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The Pacemaker
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What does it treat?

• Many movement disorders
• Tremor
• Dystonia
• Parkinsons disease
• Tourette syndrome
• Also, affective disorders
• Major Depression
• Chronic pain
• However, it is not anywhere near 100 effective
  yet for any of the above disorders

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For Parkinsons Disease

• Tremor, rigidity, postural instability
• Controls symptoms so medication is not needed
  anymore
• Mostly targets subthalamic nucleus and globus
  pallidus inerna
• parts of brain where tremors generally occur
• Pacemaker intended to stop tremor before it
  begins and control the brain activity

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Major Depression

• No evidence to support the idea that DBS helps
  depression
• However, there was a study with 6 patients
• Implanted electrodes into frontal cortex of brain
• When current turned on, 4 out of 6 patients
  reported black cloud lifting and were more
  alert
• Patients were previously resistant to meds and
  psychotherapy

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Complications/Side Effects

• Most common side effects (may only be temporary)
• Apathy
• Hallucinations
• Compulsive gambling
• Hypersexuality
• Brain shifts during surgery
• Potential for electrodes to be displaced
• Can lead to personality changes

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So, is it worth it?

• Well, no one is really sure that pacemaker
  actually works
• Placebo Effect possibly
• Very different from heart pacemaker
• Heart pacemaker either works or doesnt
• Brain is more complex in the way that it is more
  prone to a lot of change especially with age
• In conclusion, there is a lot of controversy
• Mostly ethical reasons

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Sources

• "Brain Pacemaker at AllExperts." Expert Archive
  Questions. Web. 25 Apr. 2010. lthttp//en.allexpert
  s.com/e/b/br/brain_pacemaker.htmgt.
• "Deep Brain Stimulation." Wikipedia, the Free
  Encyclopedia. Web. 25 Apr. 2010.
  lthttp//en.wikipedia.org/wiki/Deep_brain_stimulati
  ongt.
• Stein, Rob. "The Potential of 'Brain Pacemakers'"
  Washington Post (2004). Print.