Difference between revisions of "Deep brain stimulation"

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http://ve5kj6kj8s.scholar.serialssolutions.com/?sid=google&auinit=C&aulast=Fukaya&atitle=Deep+brain+stimulation+for+Parkinson%E2%80%99s+disease:+recent+trends+and+future+direction&id=doi:10.2176/nmc.ra.2014-0446&title=Neurologia+medico-chirurgica&volume=55&issue=5&date=2015&spage=422&issn=0470-8105
 
http://ve5kj6kj8s.scholar.serialssolutions.com/?sid=google&auinit=C&aulast=Fukaya&atitle=Deep+brain+stimulation+for+Parkinson%E2%80%99s+disease:+recent+trends+and+future+direction&id=doi:10.2176/nmc.ra.2014-0446&title=Neurologia+medico-chirurgica&volume=55&issue=5&date=2015&spage=422&issn=0470-8105
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http://jamanetwork.com/journals/jamaneurology/fullarticle/1391074
  
 
http://ve5kj6kj8s.scholar.serialssolutions.com/?sid=google&auinit=JF&aulast=Baizabal-Carvallo&atitle=The+safety+and+efficacy+of+thalamic+deep+brain+stimulation+in+essential+tremor:+10+years+and+beyond&id=pmid:24096713
 
http://ve5kj6kj8s.scholar.serialssolutions.com/?sid=google&auinit=JF&aulast=Baizabal-Carvallo&atitle=The+safety+and+efficacy+of+thalamic+deep+brain+stimulation+in+essential+tremor:+10+years+and+beyond&id=pmid:24096713

Revision as of 07:55, 19 April 2017

Deep Brain Stimulation of Parkinson's Disease

List of Deep brain stimulation devices:

Deep brain stimulation (DBS) is a neurosurgical technique in which electrodes are implanted into patient's brain. Although, patients have to undergo an invasive surgery, it is growing field of neurosurgery.[1] DBS proved to be cost-effective in a treatment of certain severe neurological diseases as Parkinson's disease, essential tremor, dystonia, obsessive-compulsive disorder (OCD) or epilepsy.[2] The treatment of other neurological and psychiatric diseases as depression or chronic pain is examined intensively.[1]

DBS is not a cure. None of the diseases to which is used are curable at the moment. It could however, eliminate symptoms of the diseases, which negatively affected the lives of the patients.[3] DBS is used in medical devices, which are on prescription, the use for cognitive enhancement is highly limited. However, certain cases of possible cognitive enhancement were also reported.[4]

Main Characteristics

RNS System for the treatment of epilepsy

Deep brain stimulation consists in stimulation of a brain by the electrodes, which are implanted in the brain. The electrodes are often referred as leads and are linked with pulse generator via wires. The different diseases could be treated with one device, since the output of the treatment is dependant at the position of electrodes.[5] The pulse generator could be rechargeable or non-rechargeable[6] and could be implanted in the chest[7] or under the scalp[8]. The precise function of the pulse generator is adjusted by the programmer.[5]

The surgery usually consists of two procedures. Firstly, the electrodes are implanted into patient's brain. Patient's head is fixed in a stereotactic head frame, which avoids any movement during the surgery. The patient has to be awake in order to surgeons could see the impact of the stimulation.[5] There are several electronic devices, which could help surgeons to reach the correct spot in the brain.[9] Since DBS does not require a destruction of any area in the brain, it is reversible procedure.[10] A few days later, surgeons could implant the pulse generator.[5] The patients have to visit their doctors several time after the surgery to program correctly their pulse generator. The pulse generators could deliver a various voltage and frequency and usually just a particular programme has the best effect on patient's symptoms.[9]

There are several types of deep brain stimulation. Certain devices as Activa® or Brio™ Rechargeable IPG, delivers open-loop stimulation, which means that the pulses of the current are delivered constantly. This type of devices could be also divided into constant-voltage devices, as were the first Activa® devices and constant-current devices, which is for instance Brio™ Rechargeable IPG.[11] In contrast to open-loop systems, closed-loop systems deliver stimulation only in the case the stimulation is needed.[12] The example of the closed-loop system of deep brain stimulation could be RNS® System.[13]

Historical overview

The first reported neurosurgery was conducted in South America approximately 5000 B.C. It consists in boring of holes into the scull of patients as a treatment of neurologic and psychiatric diseases. It was believed that these diseases were caused by the maleficent spirit, who would be eliminated through the hole.[2] The first deep brain stimulation was used for the treatment of human patients in the middle of the 20th century. It was focused on mental and movement disorders. The mortality rate was high, however, and the efficient drug appeared soon after the introduction of DBS. Therefore, the method was abandoned at that time.[14] In addition, FDA required a strict regulation of medical devices since 1976. Therefore, deep brain stimulation system have to proved that they are cost-effective before their used as a treatment.[15]

The renaissance of deep brain stimulation started in late 1980s, when Alim-Louis Benabid use DBS as a treatment for Parkinson's disease and dystonia. His research was accepted better than those of his precursor, even though, there were no considerable difference in his approach. The important factor was that in the period, when he is conducted his research, the neurologists were looking for an alternative to levodopa, the drug which was used as a treatment of Parkinson's disease. They faced the fact that the drug lost its effectiveness in the long run. In addition Benabid successfully identified regions in the brain which should be stimulated.[15] DBS had been provided at humanitarian device exemption at first, but it was approved as a treatment of Parkinson's disease and essential tremor in 1997. It has also pre-market approval for a treatment of epilepsy[16] and OCD[2].

Purpose

Deep brain stimulation was developed as a treatment of neurological and psychiatric diseases, in the cases when medication is unsuccessful.

Important Dates

  • about 5000 B.C. the first trephinations were conducted in South America.[2]
  • 1987 - the research on deep brain stimulation of the thalamic nucleus ventralis intermedius to treat symptoms of Parkinson's disease was published[17]
  • 1993 - deep brain stimulation of subthalamic nucleus was introduced as a treatment of Parkinson's disease.[18]
  • 1997 - deep brain stimulation was approved as a treatment of Parkinson's disease by FDA.[7]

Enhancement/Therapy/Treatment

http://ve5kj6kj8s.scholar.serialssolutions.com/?sid=google&auinit=C&aulast=Andrews&atitle=Which+patients+with+dystonia+benefit+from+deep+brain+stimulation%3F+A+metaregression+of+individual+patient+outcomes&id=pmid:20841370

http://ve5kj6kj8s.scholar.serialssolutions.com/?sid=google&auinit=M&aulast=Tagliati&atitle=Long%E2%80%90Term+management+of+DBS+in+dystonia:+Response+to+stimulation,+adverse+events,+battery+changes,+and+special+considerations&id=doi:10.1002/mds.23535&title=Movement+disorders&volume=26&issue=S1&date=2011&spage=S54&issn=0885-3185

http://ve5kj6kj8s.scholar.serialssolutions.com/?sid=google&auinit=C&aulast=Fukaya&atitle=Deep+brain+stimulation+for+Parkinson%E2%80%99s+disease:+recent+trends+and+future+direction&id=doi:10.2176/nmc.ra.2014-0446&title=Neurologia+medico-chirurgica&volume=55&issue=5&date=2015&spage=422&issn=0470-8105

http://jamanetwork.com/journals/jamaneurology/fullarticle/1391074

http://ve5kj6kj8s.scholar.serialssolutions.com/?sid=google&auinit=JF&aulast=Baizabal-Carvallo&atitle=The+safety+and+efficacy+of+thalamic+deep+brain+stimulation+in+essential+tremor:+10+years+and+beyond&id=pmid:24096713

pain - http://www.eurekalert.org/pub_releases/2016-04/uota-eso040416.php

Anorexia nervosa - http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(17)30076-7/fulltext, https://tribune.com.pk/story/1337579/scientists-test-deep-brain-stimulation-potential-anorexia-therapy/

Bipolar - http://neurocritic.blogspot.cz/2012/01/deep-brain-stimulation-for-bipolar.html

Alzheimer's disease - http://link.springer.com/article/10.1007/s10072-015-2120-6

Ethical & Health Issues

Discrepancy in the DBS programme - https://defeatparkinsons.com/2015/11/06/taking-a-closer-look-at-dbs-by-dr-de-leon/

Public & Media Impact and Presentation

https://www.youtube.com/watch?v=7wYfafhuITA

http://www.espn.com/espn/story/_/id/8194683/davis-taylor-phinney

https://www.youtube.com/watch?v=aHxd_IIbxE4

https://www.youtube.com/watch?v=fDz6R82h6qU

https://www.youtube.com/watch?v=L_c2yI5otTM

https://www.youtube.com/watch?v=Jk0TGTdCXgQ

https://www.youtube.com/watch?v=LON36XhpdDs

http://www.medgadget.com/2013/06/a-fantastic-demonstration-of-deep-brain-stimulation-for-parkinsons.html

Public Policy

Related Technologies, Projects or Scientific Research

References

  1. ↑ 1.0 1.1 GOSSET, Nathalie, DIETZ, Nicholas. IEEE Pulse [online]. Unlocking Pain: Deep brain stimulation might be the key to easing depression and chronic pain. 2015, Mar 15. Available online at: http://pulse.embs.org/march-2015/unlocking-pain/ (Retrieved 13th April, 2017).
  2. ↑ 2.0 2.1 2.2 2.3 LOZANO, Andres. Tuning the Brain. The Scientist [online]. 2013, Oct 28. Available online at: http://www.the-scientist.com/?articles.view/articleNo/38047/title/Tuning-the-Brain/ (Retrieved 12th April, 2017).
  3. ↑ U.S. Food and Drug Administration. FDA approves brain implant to help reduce Parkinson’s disease and essential tremor symptoms. U.S. Food and Drug Administration [online]. 2015, Jun 12. Available online at: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm451152.htm (Retrieved 6th April, 2017).
  4. ↑ HAMANI, Clement. et al. Memory enhancement induced by hypothalamic/fornix deep brain stimulation. Annals of Neurology, 2008, 63(1), 119–123. Doi: 10.1002/ana.21295 Available online at: http://ve5kj6kj8s.scholar.serialssolutions.com/?sid=google&auinit=C&aulast=Hamani&atitle=Memory+enhancement+induced+by+hypothalamic/fornix+deep+brain+stimulation&id=doi:10.1002/ana.21295&title=Annals+of+neurology&volume=63&issue=1&date=2008&spage=119&issn=0364-5134 (Retrieved 13th April, 2017).
  5. ↑ 5.0 5.1 5.2 5.3 NORDQVIST, Joseph. What is Deep Brain Stimulation?. MedicalNewsToday [online]. 2016, Sep 7. Available online at: http://www.medicalnewstoday.com/articles/265445.php?utm_source=TrendMD&utm_medium=cpc&utm_campaign=Medical_News_Today_TrendMD_0 (Retrieved 11th April, 2017).
  6. ↑ GILLIES, Martin J. et al. Rechargeable vs. Nonrechargeable Internal Pulse Generators in the Management of Dystonia. Neuromodulation: Technology at the Neural Interface, 2013, 16(3), 226-229. Doi: 10.1111/ner.12026 Available online at: http://onlinelibrary.wiley.com/doi/10.1111/ner.12026/full (Retrieved 11th April, 2017).
  7. ↑ 7.0 7.1 DANCE, Amber. Deep-Brain Stimulation: Decade of Surgical Relief, Not Just for PD. Alzforum [online]. 2010, May 21. Available online at: http://www.alzforum.org/news/research-news/deep-brain-stimulation-theres-still-room-improvement (Retrieved 12th April, 2017).
  8. ↑ SIRVEN, J.I. Responsive Neurostimulation. Epilepsy Foundation [online]. 2014, May. Available online at: http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/devices/responsive-neurostimulation (Retrieved 13th April, 2017).
  9. ↑ 9.0 9.1 DANCE, Amber. Deep-Brain Stimulation: There’s Still Room for Improvement. Alzforum [online]. 2010, May 25. Available online at: http://www.alzforum.org/news/research-news/deep-brain-stimulation-electrode-all-occasions (Retrieved 13th April, 2017).
  10. ↑ BREIT, Sorin. Deep Brain Stimulation. Cell and Tissue Research, 2004, 318(1), 275–288. Doi: 10.1007/s00441-004-0936-0 Available online at: http://link.springer.com/article/10.1007/s00441-004-0936-0 (Retrieved 13th April, 2017).
  11. ↑ PREDA, F. et al. Switching from constant voltage to constant current in deep brain stimulation: a multicenter experience of mixed implants for movement disorders. European Journal of Neurology, 2016, 23(1), 190–195. Doi:10.1111/ene.12835 Available online at: http://onlinelibrary.wiley.com/doi/10.1111/ene.12835/full (Retrieved 6th April, 2017).
  12. ↑ PICILLO, Marina, FASANO, Alfonso. Recent advances in Essential Tremor: Surgical treatment. Parkinsonism & Related Disorders, 2016, 22(1), S171–S175. DOI: 10.1016/j.parkreldis.2015.09.012 Available online at: http://www.sciencedirect.com/science/article/pii/S1353802015003879 (Retrieved 6th April, 2017).
  13. ↑ WU, C., SHARAN, A.D. Neurostimulation for the Treatment of Epilepsy: A Review of Current Surgical Interventions. Neuromodulation, 2013, 16, 10–24. Doi: 10.1111/j.1525-1403.2012.00501.x Available online at: http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1403.2012.00501.x/abstract (Retrieved 13th April, 2017).
  14. ↑ SCHWALB, Jason M., HAMANI Clement. The history and future of deep brain stimulation. Neurotherapeutics. 2008, Jan. 5(1), 3–13. Doi: 10.1016/j.nurt.2007.11.003 Available online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084122/ (Retrieved 13th April, 2017).
  15. ↑ 15.0 15.1 GARDNER, John. A history of deep brain stimulation: Technological innovation and the role of clinical assessment tools. Social Studies of Science. 2013, Oct. 43(5), 707–728. Doi: 10.1177/0306312713483678 Available online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3785222/#bibr79-0306312713483678 (Retrieved 13th April, 2017).
  16. ↑ Business Wire. FDA Grants Premarket Approval (PMA) for the NeuroPace® RNS® System to Treat Medically Refractory Epilepsy. Business Wire [online]. 2013, Nov 14. Available online at: http://www.businesswire.com/news/home/20131114006420/en/3073855/FDA-Grants-Premarket-Approval-PMA-NeuroPace%C2%AE-RNS%C2%AE (Retrieved 19th April, 2017).
  17. ↑ BENABID A.L. et al. Combined (Thalamotomy and Stimulation) Stereotactic Surgery of the VIM Thalamic Nucleus for Bilateral Parkinson Disease. Appl Neurophysiol, 1987, 50, 344–346 Doi: 10.1159/000100803 Available online at: https://www.karger.com/Article/Abstract/100803 (Retrieved 12th April, 2017).
  18. ↑ BENABID A.L. et al. Acute and long-term effects of subthalamic nucleus stimulation in Parkinson’s disease. Stereotact Funct Neurosurg, 1994, 62, 76–84. Doi: 10.1159/000098600 Available online at: https://www.karger.com/Article/Abstract/98600 (Retrieved 12th April, 2017).
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