A brain pacemaker…

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Can you imagine this?  Anaesthesia to kill the pain, but you’re left awake, while the surgeon drills two holes in your skull.   And, then questions and commands.  Why?  Because it’s the only way the electrodes that will be placed in your brain can be put in exactly the right place.

I know how this is, because my grandfather had something similar done some 50 years ago, when he agreed to have part of his brain frozen.  He was suffering from Parkinson’s disease, and wanted to stop shaking and stuttering.  (It worked, for a while, and then he tried something else new- L-Dopa…)

Deep Brain Stimulation (brain pacemaker)

But, the person above is hoping to counteract severe depression. And, the surgeons were seeking Brodmann 25, the portion in the cerebral cortex that controls negative moods.  Once that region is found, they sedate the patient, secure the electrodes and insert wires from her head to her chest where a battery pack is installed that sends the current to the electrodes in the brain.

Other patients are availing themselves to this new concept to treat different ailments:  Parkinson’s disease, obsessive-compulsive disorder (OCD), and dystonia.  Still others are willing to try this therapy for bipolar disorder, epilepsy, Tourette’s syndrome, and Alzheimer’s, among others.

Since 1997, more than 100,000 patients have had their tremors abated by deep brain stimulation (DBS).  And, like the patient described above, still others have obtained major relief from depression and bipolar disorder (more than ½ under remission, after these clinical trials).

The problem is that DBS only works when we find the exact region upon which the electrodes must act.  If we don’t have the locale pinpointed, then this therapy is of no utility.   And, since it is clearly invasive surgery, one won’t attempt the process without that starting point. (For example, we know that in Parkinson’s disease, the subthalmic nucleus within the basal ganglia is working overtime; for essential tremors, the almost contiguous location is the ventrointermediate nucleus.)  The concept behind the therapy is that DBS interrupts errant signals that the brain sends along its circuits, kind of like how a pacemaker works with the heart.

The results can be instantaneous, but more often one needs adjustments to medication and adjustments to the levels of stimulation (by adjusting the battery pack settings) to yield the optimum results.  And, it’s not universal.  For example, more than 85% of Parkinson’s sufferers will be helped by this technique, since it only has utility for movement/motion- not for cognitive or other health issues (which also occur as the disease progresses).  And, this does not factor in the dangers of infection or stroke, which will cause still others to be unable to benefit from this procedure.

The mysteries of the brain still confound us.

 

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48 thoughts on “A brain pacemaker…”

  1. This is interesting; will it also be effective in activating certain centers of the brain which have been inactive due to disability.Or maybe some kind of stimulation for the paralyzed? But yes, the willingness factor is a big issue. It is invasive enough to cause a lot of debates.
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  2. First, darn, I am usually first to comment, but today I had to get my hair done and take my new kitten to the vet. The odd thing is that I just posed this question to myself the other day. If there were a surgery to cure my depression would I do it? My answer is no, but for the people like my uncle who lost his life to depression and the countless throng of others that will benefit from this research, my hopes and prayers go with the technology. Amazing information, Roy, thank you!

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  4. In order to treat symptoms of ADHD-ADD as to improve functioning of the suffering individual? If so, does anyone know of someone who has been tested in such a way!

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