Deep Brain Stimulation (DBS) has helped long-suffering patients with ParkinsonÂ’s disease to engage in daily activities at an optimal level while improving the patientÂ’s quality of life. Worldwide, DBS has considerably reduced the experience of tremor and PD symptoms among the PD sufferers, in addition to considerably reducing the dosage of the medications they should take, which has renewed hope for them to live a fuller life.
It is so heart-wrenching to hear that one is being diagnosed with Parkinson disease or being struck in the prime time of life when one achieves a wealth in career or social status. This disease does not only affect them in perform simple tasks but also takes a toll on their beloved ones, friends and the people closest to them as they are extremely concerned about the progress of their PD symptoms.
PD is a progressive, debilitating, degenerative, and eventually crippling condition. This disease can significantly affect parts of the brain including neurons or nerve cells that helps coordinate and control movements, and its occurrence is usually in people around 60 years of age but it can also affect those of a much younger age.
Among Parkinson’s, Dopamine used to deliver signals in coordinating movements either cannot function efficiently or dies away. They will experience significant symptoms including trembling of face, jaw, arms, hands, legs and arms; poor coordination and balance; stiffness of the body, legs and arms; and slowness in movements. If left untreated, its symptoms will get worse over time, until suddenly they become aware that they have difficulty speaking, chewing, pronouncing, swallowing, eating, drinking, waking or performing simple routine tasks. Worse still, they will also suffer from depression, loss of confident, insomnia (sleep problem) and a chronic form of psychological problems.
Even though there is no known method to cure Parkinson’s disease, a variety of medications or surgery can help provide relieve for PD patients undergoing the drastic symptoms. Deep brain stimulation for example, can help provide the required needs to better manage and reorganize patients’ brain’s electrical impulses to help them better cope with the progressive nature of the PD symptoms that they are facing. (this is all headline?)
Renewed Hope for Parkinson’s Disease Patients
Deep brain stimulation (DBS) is a promising treatment for Parkinson’s disease (PD) patients since it was introduced extensively in the hospitals. It is, indeed, a surgical procedure used to treat neurological related symptoms, including walking problems, slowed movement, rigidity, tremors, stiffness, or a common neurological movement disorder (such as essential tremor).
Presently, DBS is used to treat those patients whose debilitating symptoms of PD cannot be adequately relieved by medications. Numerous reports have shown that those patients who had undergone the surgery procedure experienced 60% to 90% improvement in their symptoms and 50% to 60% reduction in their drug dosage.
What is Deep Brain Stimulation (DBS)?
In general, DBS uses a battery-operated, surgically placed brain pacemaker similar to a heart pacemaker device called a neurostimulator to help stimulate the brain with mild electrical signals. These signals are helpful to recognise the brain’s electrical impulses. In short, this medical device is a size of a stopwatch that assists in delivering electrical stimulation to targeted areas in the brain which is effective in controlling movements (walking for example), while blocking the abnormal nerve signals that cause PD symptoms and tremor as well.
How Is Deep Brain Stimulation Performed?
In DBS procedure, an insulated thin wire-the lead or an electrode is inserted via an opening in the skull and implanted in the brain with the electrode’s tip placed in the targeted brain area. As for multiple sclerosis and essential tremor, electrodes are normally positioned in the thalamus while for Parkinson’s disease; it is placed in the globus pallidus.
The second component of DBS system is the extension, which is an insulated wire that is passed beneath the skin of the shoulder, head, and neck connecting the lead to the neurostimulator or a battery pack like device. Near to the collarbone, the third component of DBS system- neurostimulator or a type of brain pacemaker called an impulse generator (IPG) is implanted under the skin of the collarbone, but, in certain cases, it might be planted under the skin of the abdomen or lower in the chest. Once activated, this device will help deliver continual electrical pulses towards the targeted areas in the brain, and at the same time, efficiently blocking any impulses that cause PD symptoms or tremors.
Patients with Parkinson’s disease will require having surgery done on both sides of their brain in order to position the stimulators, and during the first surgery procedure the electrodes are inserted into their brains but left unconnected.
In order to better position the electrodes in the appropriate targeted areas of the brain, magnetic resonance imaging (MRI) or a computer tomography (CT) scanning will be carried out to identify the exact area to where the electrodes is located within the brain targeted area in which electrical nerve signals generate the PD or tremor symptoms. Some surgeons may even use a small wire or microelectrode recording to specifically monitor the precise location of the brain to which it will be stimulated and in many occasions, subthalamic nucleus, globus pallidus and thalamus as well have been targeted for this purpose.
Once the exact location is identified, the electrodes will be implanted permanently. Beneath the skin of the head, the loose ends of the electrodes are positioned while the incision is closed with sutures, and a week later, patients are asked to re-admit to a hospital for a careful observation. Under general anaesthesia, the loose ends of the electrodes are disconnected from the extension wires before connecting to the impulse generators. The IPG will only be turned on and adjusted 2 to 4 weeks later. Definitely, this procedure will take several weeks until the simulators and drugs can be adjusted accordingly so that the patients can experience relief of PD or tremor symptoms.
It is indeed good news to know that PD patients have achieved encouraging progress with deep brain stimulation which is truly a promise for Parkinson’s. Once the system is residing within the brain, a brain pacemaker implant will stimulate the brain with mild electrical impulses delivering from the neurostimulator up along the extension wire that leads to the brain. This will in turn help organize the brain’s electrical impulses efficiently and correctly. Meanwhile, these impulses are useful particularly in blocking any electrical signals that cause or initiate PD related symptoms.
How Does DBS Benefit PD Patients?
The good thing about DBS stimulation is that it causes fewer side effects since this procedure kills neither nerve cells nor healthy brain tissue. Besides that, the neurostimulator can be easily adjustable without undergoing further surgery procedure and it has helped many patients to live to the fullest.
DBS offers promising treatment and hope for long-suffering patients, enabling them to do tasks including walking, buttoning their shirts, holding a cup properly without having content being spilled, driving and even having a good, undisturbed night’s sleep. As they gain better control of their movements, they can contribute to family by working and performing routine activities. DBS, not exaggeratedly, has benefited many patients to engage in daily activities at an optimal level while leading an enriching life. In particular, DBS has brought back their dignity to live and hope to live in a fullest life.
Worldwide, DBS has considerably reduced the experience of tremor and PD symptoms among the PD sufferers, in addition to considerably reduce the dosage of the medications they should take. In other words, DBS has renewed the hope for helping PD patients to overcome a degenerative disorder of the central system that is known to impair the patient’s speech, motor skills and other neurological functions.
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