By Niritta Patel (NHS ’19)
Recently, a surgical treatment called deep brain stimulation (DBS) has been found to be successful in reducing tremors and increasing mobility in Parkinson’s patients. Rather than harming nerve cells, DBS aims to target areas within the brain and to block abnormal electrical signals responsible for symptoms.
Parkinson’s disease plagues approximately one million people across the country. Its impact on the substantia nigra within the brain decreases the production of dopamine, a hormone responsible for the body’s coordination and movement. This reduction of dopamine is typically the agent for chronic symptoms such as tremors, rigidity of the limbs, and inability to maintain posture, making it difficult for people to live their lives with much normalcy.
Prior to beginning the procedure, neurosurgeons detect specific brain areas which propagate abnormal electrical signals contributing to symptoms. This is done with the help of magnetic resonance imaging (MRI) and computed tomography (CT). Regions such as the thalamus and subthalamic nucleus are often targeted. To increase specificity, many neurosurgeons also rely on microelectrode recording, in which a small wire helps monitor nerve cell activity in the targeted brain area. After this preliminary measure, DBS is carried out with the help of three components: the lead, the extension, and the neurostimulator.
The lead is an insulated wire which is embedded in the targeted brain area after being inserted through the skull. The extension is a thinner wire used to connect the lead to the neurostimulator, and it is typically located within the skin of the head, neck, or shoulders. Lastly, the neurostimulator is inserted underneath the skin surrounding the collarbone, although it may also be implanted within the skin near the chest or abdomen. This component is the source of electrical impulses used to block abnormal signals.
Once these components are assembled, the electrical impulses that originate in the neurostimulator move along the extension wire and into the targeted brain area through the lead. Once there, the electrical impulses are able to block abnormal electrical signals in the targeted brain area, thereby reducing the effects of symptoms.
DBS has shown remarkable progress in alleviating symptoms such as tremors and enhancing mobility of the limbs. In addition, it reduces the need for patients to soothe their symptoms using medication. Being a relatively new technique, it is suited for people who cannot successfully use medication to ease their symptoms and who are experiencing difficulties maintaining their normal routines due to their symptoms. Though this method can only relieve symptoms and not fully get rid of them, this is an onset to someday ending the encumbering ways of Parkinson’s disease.