What is Deep Brain Stimulation
 



Deep brain stimulation:

Deep brain stimulation is a new innovative neurosurgical treatment in which medical device called brain pace maker which is pretty much like a heart pace maker is implanted in specific part of the brain. The device sends out the electrical impulses to treat variety of disabling neurological syndrome.

DBS is most known for treating Parkinson’s symptoms. However, it is being used for other neurological disorders like tremor, rigidity, stiffness, slowed movement, depression and walking disorders.The advantages of DBS is that it dosn't damege the ehalthy brain tissued.On the ohter hand it dons't destory the nerve cells.DBS is currently being used for only the patient  whose symptoms cannot be treated by medications.

Main componatns:

  1. Neurostimulator which is  a battery operated device and similar to heart pace maker is implanted to electricly stimulated the targeted area in the brain and interfear with neryual activity
  2. The lead: A coiled wire coated with polyurethance and contains four platimum iridium electrodes.

The lead is placed in one of the three areas of the brain and is connected to neurotransmitor. Lead is connected by extension to the stimulator it goes from the head down to the neck and finally to the stimulator.

The placemat of the lead depends on the type of the disease and symptoms. For example for essential tremor the leas Is implanted in ventrontermedeal nucleus, VIM, of the Thalamus.

For Dysotnia and some Parkinson’s associated symptoms, the lead is placed in either subthalamic nucleus or globus pallidus.

 

Only local anesthesia is applied as the feedback of the patient is crucial. A 14 mm hole then is drilled into the skull and through that electrode is implanted. At this time with the help of patient and feedback the optimal placement can be obtained.

Biochemistry behind DBS:

According to  researchers at university of Rochester in New York, DBS is associated with increase in ATP level which result in accumulation of adenosine. The adenosine receptor then get active which in turns depress excitatory transmission in the thalamus which reduces both DBS induced side effect and tremor. According to the experiment that they’ve done on mice, the intrathalamic infusion of A1 receptor reduces tremor, however, adenosine A1 receptor cause involuntary movements and even seizure at stimulation intensities below the therapeutic level. And they concluded that nonsynaptic mechanisms that involves in the activation of A1 process supers tremor activity and limit stimulation induced side effects. And thus finding a new pharmacological target is essential to replace or improve the efficacy of Deep brain stimulation.












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