Electrical stimulation for the brain? Let's learn about Deep Brain Stimulation (DBS) in simple terms

Does a family member or friend of yours have Parkinson's disease or an uncontrollable tremor ? Sometimes, even with medication, it's frustrating when things get worse day by day, but there's no significant improvement. Today, we're talking about a new, promising treatment that has emerged with the advancement of medical science. This is called Deep Brain Stimulation, or DBS for short.

What is Deep Brain Stimulation (DBS)?

Simply put, DBS is a medical procedure that delivers a very small electrical current to a specific part of your brain. Think of it like a pacemaker for the brain. In this, a small device is implanted under the skin near your collarbone. It sends electrical signals to the right part of your brain through one or more very thin wires. These electrical signals re-stimulate the brain's dormant cells. This can control the symptoms of several conditions.

Who needs this treatment and why?

The nerve cells in our brain, called neurons , communicate with each other through electrical and chemical signals. Some diseases can cause the activity of these neurons in certain parts of the brain to decrease. Then the functions controlled by those parts do not work properly. For example, if neurons in a part that controls movement become inactive, it becomes difficult to walk or control your limbs.

DBS treatment uses an artificial electrical current to reactivate dormant neurons, but researchers are still studying exactly how it works.

How is the surgery performed?

This procedure is not really a one-time surgery. It is usually completed in two or three surgeries performed on different days.

Preparation before surgery

Before the surgery, your doctor will explain the pros, cons, and risks of this treatment to you. He or she will also order several tests, such as an MRI or CT scan, to see if you are a good candidate for the surgery. Also,

• Talking about medications: You may be asked to stop taking some medications, especially blood thinners, before surgery. But never stop taking any medications without your doctor's advice.
• Cleaning: You may be asked to use a special shampoo or soap to prepare your scalp and skin for surgery.
• Fasting: In thisBecause you will be under anesthesia , you will need to stop eating 8 hours before surgery and drinking fluids 2 hours before.

During surgery

First stage: Lead placement

This is the most important surgery. First, your head is fixed in a special frame to keep it still. Then, a very small hole is made in your skull, and thin wires with electrodes are inserted through it to the right place in your brain.

After this, you will be kept under observation in the hospital for about a day and then sent home.

Second stage: Pulse Generator Placement

This surgery is done on a separate day. You will be given general anesthesia. A small incision is made in your neck, a small space is created under the skin, and the battery pack (pulse generator) is inserted into it. Then, the wires that go to your brain and this battery are connected under the skin, and the incision is closed. You can go home the same day after this surgery.

What happens after surgery?

A few weeks after surgery, you will need to see your doctor. That's when the battery pack (pulse generator) will be programmed. That means adjusting the amount and pattern of electrical signals to match your symptoms. You may need to see your doctor several times until this is just right.

The batteries in these devices usually last 3-5 years. Some newer devices have rechargeable batteries, which last about 9 years. Even changing the battery requires a minor surgery.

When to see a doctor

Since DBS is a brain surgery, we need to be very careful about certain warning signs. If any of the following symptoms occur, call your doctor immediately or go to the hospital's Emergency Department (ETU).

• Sudden or persistent severe headache .
• Bleeding from surgical incisions.
• Redness, swelling, or an unusual feeling of warmth around the incision (these are signs of infection).
• Sudden changes in vision (double vision, blurred vision).
• Fever of 38.3 Celsius (101 Fahrenheit) or higher.

Common questions about living with a DBS device

Can I use electronic devices?

This device is not affected by household appliances such as microwaves, computers, and smartphones. It may be affected by metal detectors at airports. You will be given a special ID card to use at such times.

Can I have an MRI scan?

No. This is very important. A person with a DBS device cannot usually have an MRI scan because the strong magnetic field in the MRI machine can damage the DBS device. Therefore, it is imperative that you inform your doctors that you have a DBS device before undergoing any medical treatment.

Does DBS completely cure the disease?

No. DBS is not a cure. It is designed to control symptoms and improve quality of life.