The Department of Neurosciences at Vimhans Nayati is a centre of excellence offering state of the art facilities and treatment options for a wide array of neurological conditions. Being the leading pioneer of technology in the field of medicine we offer all the latest procedures including Deep Brain Stimulation that has revolutionized neurological treatments. Commonly known as DBS, the procedure involves the surgical placement of a special device, known as a neurotransmitter or brain pacemaker in the chest of the patient so as to generate impulses and send them to the electrodes placed in the brain via conducting wires, to control abnormal brain activity.
DBS system consists of the following 3 components:
- The impulse generator is commonly referred to as a neurotransmitter. It is placed beneath the skin in the chest cavity.
- The electrodes are surgically placed in the affected area of the brain.
- The insulated extension wire that connects the electrode to the pulse generator.
Conditions that are treated using Deep Brain Stimulation
Deep brain stimulation has been found to be effective in treating the following neurological conditions:
- Dystonia – It is a movement disorder triggered by muscle contractions that are beyond one’s control. As a result of these contractions, the patient is likely to experience involuntary twisting, uncontrollable & repetitive movements, and abnormal posture. The condition can either affect a single muscle or a group of muscles simultaneously.
- Epilepsy – Epilepsy is a neurological disorder triggered by abnormal brain activity that results in recurrent seizures, unusual behaviour, and even loss of awareness. The problem can affect people of all age groups and gender.
- Parkinson’s Disease – Marked by uncontrollable shaking and stiffness that is likely to interfere with normal activities like walking, balancing, or even holding objects, Parkinson’s disease is a progressive neurological condition that tends to worsen with time. The condition usually starts as barely noticeable tremors in a specific part of the body that gradually radiates to other parts.
- Stroke – Stroke is a condition triggered by the loss of blood supply to the brain which may be a result of many factors. The deficiency of oxygenated blood causes the brain cells to die and can even lead to physical or mental disability.
Apart from these major conditions, some other conditions that can be addressed using deep brain stimulation include:
- Essential tremors
- Obsessive-compulsive disorder
- Cluster headaches
- Dementia
- Traumatic brain injuries suffered in an accident
- Major depression
- Huntington’s disease.
How to prepare for the procedure
Before initiating the procedure, you will be required to undergo certain tests and screenings to make sure that you are eligible for the procedure. This is important to weigh all the potential outcomes and personalize the whole treatment plan to yield the best results for the patient.
What happens during the procedure?
Deep brain stimulation surgery is broadly divided into two parts, the first one involving the placement of the electrodes and the second involving the placement of the neurotransmitter.
The brain surgery involves the use of a stereotactic head frame to keep your head during the surgery. The procedure is carried out using MRI (Magnetic Resonance Imaging) facility so as to determine those areas of the brain where the electrodes are to be placed. The patient is first sedated using general anaesthesia or local anaesthesia such that he/she does not feel any pain or discomfort. The electrodes that are fixed on thin wire leads are implanted on both sides of the brain. The brain activity of the patient is keenly observed throughout the procedure to make sure that the electrodes are placed correctly.
The chest wall surgery is also carried out using general anaesthesia. It involves the placement of the neurotransmitter on the pulse generator beneath the skin on the chest cavity. The leads coming from the electrodes are connected to this pulse generator. The generator is then programmed to suit the specific needs of the patients. You can also increase the intensity of the pulses using a special remote-control device.
What to expect after the procedure?
It is pertinent to know that the pulse generator is not activated right after the surgery but almost a week after it. The neurotransmitter can be controlled very easily using a special remote-control device which helps to customise the intensity of the pulses as per the requirement of the patient. Depending upon the condition to be treated and overall health evaluation of the patient the simulation can be constant or you may be advised to turn the device off during the night. Also, the battery life of the neurotransmitter varies from one person to another depending upon the usage. The batteries are to be replaced surgically which is usually carried out as an outpatient procedure.
Benefits of Deep Brain Stimulation
Although deep brain stimulation may not completely cure your disease, it can help to make a big difference. The procedure not only helps to alleviate the symptoms but also helps to slow down the progress of the disease. Deep brain stimulation can help to improve the quality of the patient's life and has been successful in doing so ever since its advent.
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