» Posts in the Deep Brain Stimulation Category:

Deep Brain Stimulation in Alzheimer’s Disease

Walter van den Broek
December 22, 2011
Read a review on the use of deep brain stimulation (DBS). Wrote a lot of posts about this new treatment on this blog, mostly for treatment resistant depression. As with most new treatment options the new treatment is tried with other severe diseases. You can probably find some on this blog or down this post in the related posts section. The use of DBS in Alzheimer's disease drew my attention. Stimulating certain brain regions in a disease with a neurodegenerative character seems almost impossible. This review was written by members of the Canadian group who also published about the use .....read more »

Long Term Efficacy of Deep Brain Stimulation

Walter van den Broek
July 4, 2011
New long term data on efficacy of deep brain stimulation for treatment resistant depression are available. The first follow up data up to 1 year were already promising. Published research about deep brain stimulation for treatment resistant depression showed that six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. The average response rate to DBS after two and three years were 46,2% and 75%. More than one-third of patients were in remission at year 3. But what's more convincing functional impairment in the areas of physical .....read more »

Optimal Target for Deep Brain Stimulation for Depression

Walter van den Broek
February 9, 2010
The strongest evidence exists for Broadman Area 25 in the subcallosal cingulate gyrus (SCG) as target for deep brain stimulation in treatment resistant depression. This area in the brain is depicted in the figure above and is from the most important publication about DBS and depression in Neuron march 2005 by Helen Mayberg. Functional neuroimaging as well as antidepressant treatment effects suggest that this area plays an important role in modulating negative mood states. A decrease in activity is reported with clinical response to antidepressants and electroconvulsive therapy (ECT). But depression is not a disease of a single brain region nor .....read more »

Deep Brain Stimulation Animation

Walter van den Broek
November 15, 2009
Excellent animation of deep brain stimulation thanks to the Cleveland Clinic ..read more »

New Kind of Brain Stimulation for Treatment Resistant Depression

Walter van den Broek
October 20, 2009
In a recent online publication about another form of brain stimulation in treatment resistant depression showed promising results. The electrodes are placed on the brain instead of in the brain as with Deep Brain Stimulation (DBS): A new neurosurgical procedure may prove helpful for patients with treatment-resistant depression. Bilateral epidural prefrontal cortical stimulation (EpCS) was found generally safe and provided significant improvement of depressive symptoms in a small group of patients The location for Brain Stimulation in EpCS targets electrical stimulation to the anterior frontal poles and the lateral prefrontal cortex. Two different places on both hemispheres, resulting in four separate paddle .....read more »

New Innovations in Deep Brain Stimulation Surgery

Dr Shock
September 14, 2009
A great step forward, patients don't have to be awake during the procedure. This video shows a clear description of the old and new procedure for deep brain stimulation (DBS). In the old procedure a frame has to applied after which a brain mapping procedure has to follow, up to 6-8 hours while the patient has to be awake. At the end the patient has to undergo a MRI to see whether the electrodes are in the right place. All very tedious and time consuming. The new procedure takes place in the MRI with anesthesia and takes less time (50%). .....read more »

Ethical Guidelines for Deep Brain Stimulation

Dr Shock
June 3, 2009
Deep Brain Stimulation (DBS) should only be used when there is a high change that the lives of patients will be improved by its use and when all other possible interventions have been tried Patients must be fully informed and informed consent must be obtained The whole procedure should be done by teams of appropriate specialists like neurosurgeons, neurologist, psychiatrist and other health professionals that can help the patient before during and after the operation and who will continuously monitor the patient The procedure should help restore (but not augment) normal function, should provide relief from pain and distress, and should never be .....read more »

How deep brain stimulation works for Parkinson’s Disease

Dr Shock
May 11, 2009
Alleviating Parkinsons through deep brain stimulation from Science News on Vimeo. Deep Brain Stimulation (DBS) is mostly used for Parkinson's Disease. DBS for Obsessive Compulsive Disorder and Depression is just starting to be used. It is unclear how DBS works for Parkinson's Disease. With DBS an electrical probe is inserted into the brain and it stimulates an area known as the subthalamic nucleus. This can help people with Parkinson’s disease overcome the disorder’s neurological block on movement. But how does this stimulation work. Some researchers think the technique stimulates neurons that initiate movement. Others say it blocks inhibitory neurons, allowing brain signals .....read more »

Is deep brain stimulation neuroprotective if applied early in the course of Parkinson’s Disease?

Dr Shock
March 24, 2009
This is an important question. until now all medication for Parkinson's disease relieved the symptoms of this disease for a while. The medication couldn't prevent the progression of the disease resulting in lack of efficacy of the medication. Increasing the dosage until side-effects or adding another therapeutic temporarily resolved the symptoms until the progression again decreased their efficacy. Hundreds of putative neuroprotective agents have been tested in clinical trials over the past two decades, but none of these agents has been successful at preventing the progression of PD. In a recent Viewpoint in Nature Clinical Practice Neurology the authors claim that: We believe .....read more »

Deep Brain Stimulation for Treatment Resistant depression

Dr Shock
February 24, 2009
New data are being published about deep brain stimulation and treatment resistant depression. Especially longer follow up is of importance. In recent published research about deep brain stimulation for treatment resistant depression, six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months. Moreover, there was no significant loss of effect requiring dose adjustments over time. So once a good stimulus dose, high change that it will remain that way over a long period of time. With DBS for TRD symptoms typically return rapidly if the device is turned .....read more »