What Is Deep Brain Stimulation?

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What Is Deep Brain Stimulation?

Deep brain stimulation (DBS) is a surgical treatment used for movement disorders and some treatment-resistant mental disorders.

Electrodes are surgically implanted into parts of the brain where abnormal activity is occurring. The electrodes emit impulses that manage irregular brain activity. A generator controls the brain stimulation, which, much similar to a pace-maker, is placed in the upper chest. The generator connects to the electrodes through a wire tracing under the skin from the chest to the brain.

The electrodes usually stimulate the brain bilaterally, meaning that both sides of the brain are receiving stimulation. However, there are some conditions where the electrode treatment must be unilateral, meaning they are only stimulating one side of the brain. 

Deep brain stimulation treatment commences once the recovery process after the surgery is complete, which usually takes a few weeks. A medical provider will turn the generator on and begin the process of finding the best settings for the allocated treatment. This can prove to be a bit uncomfortable at first, with an early side effect being speech issues. However, this is usually temporary. 

History of Deep Brain Stimulation

In 1987, French neurosurgeon Alim Benabid discovered that electrical stimulation on the basal ganglia could relieve symptoms of Parkinson’s disease. This discovery triggered a groundbreaking moment in healing movement disorders.

One decade later, deep brain stimulation was approved by the Food and Drug Administration (FDA) in 1997 to treat Parkinson’s disease-related tremors. 

In 2009, deep brain stimulation for obsessive-compulsive disorder was introduced. Since then, the use of this elective surgical procedure has treated depression, epilepsy, and Tourette syndrome. Less commonly, but effectively, this treatment has also been used for chronic headaches, addiction, obesity, and stroke recovery.

Though deep brain stimulation, as the public generally understands it today, was introduced in the late 1980s, it has earlier roots. In the late 19th century, deep brain stimulation was discovered by stimulating the cerebral cortex of animals. This early experience was foundational in future explorations of deep brain stimulation.

Types of Deep Brain Stimulation

Deep brain stimulation therapy is part of a broader scope of brain stimulation therapies. Deep brain stimulation is one of the most commonly known stimulation therapies. Electroconvulsive therapy (ECT) is a highly controversial and widely studied brain stimulation therapy that is still used to this day. Electroconvulsive therapy is used in the treatment of major depressive disorder and bipolar disorder.

Other forms of brain stimulation therapies include:

  • Vagus nerve stimulation (VNS): Vagus nerve stimulation was initially used to treat epilepsy, though it is also now used to treat depression. It is similar to deep brain stimulation—it also uses a device planted under the skin that triggers electrodes to deliver electric pulses. However, the electrodes are planted on the vagus nerve, instead of the brain. 
  • Repetitive transcranial magnetic stimulation (rTMS): Repetitive transcranial magnetic stimulation can treat depression, psychosis, anxiety, and other mental illnesses. It was developed in 1985 and uses a magnet to activate the brain. The part of the brain that is activated is dependent upon the presenting condition.
  • Magnetic seizure therapy (MST): Magnetic seizure therapy is a newer form of brain stimulation that is used to treat mental disorders, such as major depression and bipolar disorders. Magnetic seizure therapy uses magnetic pulses to stimulate the brain to induce a seizure.

What Is Deep Brain Stimulation Used For?

Deep brain stimulation is helpful both for neurological and treatment-resistant psychological disorders. It can treat movement disorders like the aforementioned Parkinson’s disease, tremors, and dystonia. Psychological disorders can also benefit.

For example, treatment-resistant depression can benefit from deep brain stimulation. While initial studies have been promising, it has yet to be cleared by the FDA and is still considered an experimental treatment.

Treatment-resistant obsessive-compulsive disorder is successfully treated by deep brain stimulation, as well. 

Deep Brain Stimulation Benefits and Considerations 

The greatest benefit deep brain stimulation offers is the opportunity to finally feel relief. Particularly in the case of psychological disorders, it can work wonders on conditions that simply have failed to respond to other forms of treatment.

In the event that other treatments are not soothing the symptoms of a mental illness like depression or obsessive-compulsive disorder, deep brain stimulation can offer some relief.

While deep brain stimulation is an effective treatment, it does require surgery. For many, the stress of undergoing an elective surgical procedure may be a major deterrent. 

Potential Pitfalls of Deep Brain Stimulation

Deep brain stimulation is a serious medical procedure. For those receiving deep brain stimulation for neurological disorders, there can be negative psychological side effects.

For example, a study on those experiencing Parkinson’s disease revealed an increased likelihood to develop depressive symptoms after the surgery. However, these symptoms can subside and, if needed, medical providers can adjust the treatment accordingly.

Other general side effects include infection, headache, and device malfunction. Some may experience speech issues and fatigue. It is worth noting that side effects are rare and can be managed with adjustments to deep brain stimulation and medical attention.

A Word From Verywell

Living with a treatment-resistant psychological condition can feel isolating and disheartening. If you find yourself losing hope in your pursuit of proper treatment, reach out to your medical provider to see if this treatment could provide relief.

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