Deep brain stimulation (DBS) is a
treatment option for people with advanced Parkinson's disease. It uses one or
two surgically implanted medical devices called neurostimulators, similar to
cardiac pacemakers, to deliver electrical stimulation to precisely targeted
areas on each side of the brain. This is commonly called deep brain
stimulation. Stimulation of these areas appears to block the signals that cause
the disabling motor symptoms of Parkinson's disease. As a result, many patients
achieve greater control over their body movements.
What are the components of a DBS
system?
A DBS system includes three
components, which are implanted completely inside the body.
-
Neurostimulator – a pacemaker-like device that is the power
source for the system. It contains a small battery and computer chip
programmed to send electrical pulses to control Parkinson's disease
symptoms. There are rechargeable and non rechargeable
stimulators. The patient and physician will determine which one is better depending
on the disease condition and personal preferences.
-
Lead – an insulated wire with four electrodes.
-
Extension – an insulated wire placed under the scalp
that connects to the lead and runs behind the ear, down the neck, and into
the chest below the collar-bone or the abdominal area where it connects to
the neurostimulator.
Which areas of the brain are
stimulated?
With the DBS one of two areas may
be stimulated: either the subthalamic nucleus
(STN) or the internal globus pallidus (GPi). These structures are deep within the
brain and involved in motor control. These structures control movement and
muscle function. A DBS multidisciplinary group of physicians including a
neurosurgeon and a neurologist, determine which structure will be stimulated.
Who is a candidate for DBS?
DBS is used for Parkinson's
patients in the advanced stages of the disease. Patients must be
‘levodopa responsive’. This means the
primary symptoms respond to the drug levodopa. A person's age or pre-existing medical condition does not
necessarily exclude him or her from becoming a candidate for DBS. A doctor
considers all factors before determining if a patient is a good candidate.
