Discovering the Benefits of Deep Brain Stimulation (DBS)

Deep Brain Stimulation (DBS) is a neurosurgical procedure that uses implanted electrodes and electrical stimulation for the treatment of movement disorders caused due to Parkinson's disease (PD), Dystonia, Essential tremor, and other neurological diseases.

In this elective surgical operation, electrodes are inserted into specific parts of the brain. These electrodes, often referred to as leads, generate electrical impulses that are utilised to control abnormal brain activity. The electrical impulses can also correct the chemical imbalances in the brain that lead to various illnesses. The stimulation of different areas of the brain is controlled by a programmable generator positioned just below the skin in the upper chest.

There are three different parts to the DBS system:

1.    The electrode, often known as the lead, is a tiny, insulated wire that is implanted into a specific part of the brain through a small incision in the skull.
2.    In order to link the electrode to the internal pulse generator (IPG), an extension wire that is also insulated and inserted under the skin of the head, neck, and shoulder is used.
3.    The third component of the system, the IPG, is typically implanted in the upper chest under the skin.

What are the benefits of Deep Brain Stimulation (DBS)?

There are many benefits of DBS. These consist of:

●    Providing a treatment alternative when medicines aren't effective - When medications are ineffective or lose their beneficial effects, DBS is a possible option. Since Parkinson's disease treatments gradually lose their beneficial effects over time, your doctor may need to increase your dosage, which can have further adverse consequences and compliance issues and expenses. However, with DBS, fewer medication dosages can be effective again, resulting in better symptom control with fewer side effects.
●    Life-changing or life-saving treatment – Certain Neurological issues that can cause severe adverse effects, make even the simplest of actions difficult, can be effectively controlled or treated with DBS. DBS can help manage these conditions, reduce symptoms, thus improving the overall well-being.
●    Adjustable - The pulse generator parameters can be adjusted by the neurologist/neurosurgeon  to obtain optimum/best response.
●    Reversible - If DBS doesn't work or has adverse effects on the patient, a follow-up surgery can be used to remove the leads and pulse generator.
●    Better quality of Life - Additionally, it could enhance your ability to carry out daily tasks such as dressing, getting out of a chair, and walking. As a result, both your freedom and quality of life will increase.

Who is the candidate for Deep Brain Stimulation?

DBS is just not a mere surgical procedure. Patients in whom DBS is indicated, have to be mentally prepared for the entire preoperative evaluation, multiple consultations to ascertain how much benefit can the patient get post surgery, it also involves series of evaluations to titrate the best optimum dose for the patient. These patients and their families thus have reasonable expectations and clear understanding of the extent of benefit, hazards and success rates of the procedure. The expectations from the procedure should be realistic both for the doctor and also for the patient. Having said this DBS does have the potential to significantly enhance the quality of life for a select group of people and reduce Parkinson's disease-related movement symptoms, but it is unlikely to make anyone completely healthy again.

Right Candidates for DBS should fulfil the following requirements:

●    Patients with uncontrolled tremors, not controlled by medicines.
●    Despite taking the right amount of medicine, symptoms remain uncontrolled.
●    Patients who may benefit from taking higher or more frequent medication dosages but are constrained from doing so due to negative effects.
●    Candidates with Essential Tremor or Dystonia, Parkinsons Disease.
●    Individuals who have Tourette syndrome, OCD, or depression.

Diagnosis of Deep Brain Stimulation (DBS)

Patients need multidisciplinary evaluation for treatment from a team of Neurologist, Neurosurgeon, and a Psychiatrist. Testing of motor symptoms, both on and off medication, is frequently conducted on Parkinson's disease or tremor patients to determine the severity of the condition. Electroencephalography, along with more sophisticated testing, may be used in epilepsy diagnosis. During the examination, certain patients could undergo neuropsychological testing.

Before DBS surgery, patients undergo the following tests:

●    Blood and urine tests
●    MRI and/or CT scans

What happens before Deep Brain Stimulation (DBS)?

The patient will require medical evaluations before the DBS procedure to confirm that deep brain stimulation is a safe and suitable alternative for them. Prior to the operation, brain imaging tests, including an MRI, may also be necessary. These investigations help in mapping the regions of the brain where electrodes will be inserted. The doctor will also discuss the patient's medications with them before the surgery.

What happens during Deep Brain Stimulation procedure?

This surgery requires two to three procedures, which often take place at various intervals. The initial one or two operations include the simultaneous or sequential insertion of stimulation into either side of the brain. The stimulator battery, often referred to as a pulse generator, is implanted beneath the skin of the upper chest during the second surgery.

To administer IV fluids before these procedures, the doctor will often implant an intravenous (IV) line. Additionally, if needed, they may provide medicine throughout the treatment through this IV.

What happens after Deep Brain Stimulation (DBS)?

A few weeks after the pulse generator implantation operation, the doctor schedules a follow-up visit to begin setting up the pulse generator. Every pulse generator currently in use includes a wireless antenna, allowing the physician to access and modify the device from outside the patient's body. Achieving the pulse generator's ideal settings may require multiple visits and some time. The use and settings of the generator can affect its battery life. When the battery needs to be changed, the surgeon will replace the generator during an outpatient operation.

Recovery after Deep Brain Stimulation procedure

After undergoing brain surgery to insert the DBS leads, the majority of patients will need to stay in the hospital for one day. Overall, the healing process often takes many weeks. Most likely, the physician will instruct you to:

Abstain from all activities, including the smallest ones like for around two weeks after each procedure.
●    Refrain from moderate to intense exertion for at least six weeks.
●    Exercise with caution when extending or moving your arms above your head for a few days following the pulse generator implant operation.

Risks or Complications of DBS

As DBS is a surgical procedure, there may be certain difficulties and risks. Among the potential complications of surgery are:

●    Infections
●    Blurry Vision
●    Lead repositioning or wrong placement
●    Lead wires from the pulse generator coming loose
●    Coordination and balance problems
●    Coma
●    Stroke
●    Inflammation or pain near the pulse generator
●    Internal bleeding or bleeding at the site of your incisions
●    Lead or pulse generator failure
●    Swelling within and outside of the brain.

DBS Procedure at Hinduja Hospital

Hinduja Hospital is one of the top Deep Brain Stimulation (DBS) hospitals in Mumbai. We provide Deep Brain Stimulation (DBS) with unmatched patient care and hospital expertise. We have the highest-ranking doctors and cutting-edge technologies under one roof, guaranteeing that patients get the right kind of treatment. We work hard to transform Hinduja Hospital into a premier, patient-focused facility where we offer our patients the highest calibre of care and treatment, while achieving the finest clinical outcomes. If you are looking for the best Deep Brain Stimulation (DBS) hospitals in Mumbai, call us today.

FAQs

Q1. How long will DBS's advantages persist?

Ans. Each patient is unique. Benefits can continue for up to 10 years for the majority of patients.

Q2. Are there any side effects of DBS?
Ans. Most patients don't experience any long-term adverse effects. Speech and coordination problems are common. A DBS programmer or neurologist can adjust the IPG to lessen or eliminate negative effects.

Q3. How long does it take to get the full benefit of DBS?

Ans. For DBS to be as effective for you as possible, it often takes a few months. To fully benefit from it, one might need to schedule the IPG adjustment multiple times.