Deep Brain Stimulation

Presented by:

Debasish Mondal

4th year BME,NSEC4/7/2017 1Deep Brain Stimulation

CONTENTS

• INTRODUCTION• DISEASES TREATED USING DBS• COMPONENTS• PLACEMENT OF THE COMPONENTS• METHODOLOGY OF SURGERY• LIMITATIONS OF DBS SURGERY• RISK OF DBS SURGERY• FUTURE SCOPE AND ENHANCEMENT• CONCLUSIONS• MANUFACTURING COMPANIES• REFERENCES

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What is Deep Brain Stimulation?

• Deep Brain Stimulation(DBS) is a surgical treatment which implants a medical device called a Brain Pacemaker.

• DBS sends electrical impulse to specific parts of the brain which need to be stimulated

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Illnesses Treated

DBS in selected brain regions has provided effective benefits for the diseases such as,

(i) Parkinson’s Disease

(ii) Chronic pain

(iii) Tremor

(iv) Dystonia

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Target sites of Brain

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Components of DBS

The pacemaker consist of

• Electrodes

• Lead wire

• Pulse generator

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Methodology of Surgery

• Step 1:Attachment of stereotactic frame.

• Step 2: Take MRI or CT scan

• Step 3: Skin and Skull incision

• Step 4: Insert electrode in the brain

• Step 5. Stimulate the brain cells

• Step 6: Closure

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Fig-I Fig-II

Fig-III Fig-IV

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Limitations of DBS surgery

• It is expensive

• The selection of patients. DBS is not used in the following patients,

Patients with a previous Surgical Ablation procedure

Patients who are pregnant

Patients under the age of 18 and above

the age of 75.

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Risks

Risks associated with surgery• Intracranial Bleeds (12%)• Seizures (3%)• Headaches (25%)• Infection (6%)

Device complications• Probe replacement (9%)• Wire replacement (6%)• Repositioning of the probe (8%)• Replacement of pulse generator (17%)• Risk of Death < 1%

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Benefits

• Reduce their medications , thus minimizing the side effects of drugs.

• Electrical impulses can be adjusted.

• Both cardiac pacemaker and brain pacemaker can be used simultaneously by the same person.

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Future scope and Enhancement

• Focuses on,

The device which automatically senses the need for increased voltage.

Improving longevity.

Reduction in size.

Reduction in cost.

Low risk.

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Manufacturing companies

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Conclusions

• Advances in the neurosciences will continue to drive the applications of DBS.

• Finally, innovations in biomedical engineering and technology will continue to be applied to DBS.

• The ideal platform for the development of these innovations is the active collaboration between basic scientists, engineers and clinicians.

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References

• http://www.medscape.com/viewarticle/813942_3

• https://www.ncbi.nlm.nih.gov/pubmed/24175861

• https://en.wikipedia.org/wiki/Dystonia

• http://journal.frontiersin.org/article/10.3389/fnins.2016.00173/full

• http://alliancebiomedica.com/index.php?route=product

• BOOK: Clinical Physiology By U K Mishra & J Kalita

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