Deep Brain Stimulation
LATEST NEWS: 5 June 2018
http://www.viartis.net/parkinsons.disease/news/180605.pdf
= == = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = =
The risks of brain surgery for Parkinson's disease
Stereotactic Technique of Deep Brain Stimulation (DBS):
DBS requires the use of the opening cranium operation in order to implant the stimulated electrodes by using the CRW stereotactic heads, after a three dimensional image has been viewed by the computer, the coordinates of the nervous nuclei can be determined.
The purpose of the DBS pulse generator is to stimulate the functional dopaminergic neurons to release more dopamine in order to relieve the symptoms.
The advantages include lessening the amount of the dosage of dopamine medication and to improve the patient´s quality of life.
The disadvantages include a limited amount of effective time for the curative effect and the patient can only undergo the operation one time. Long-term electrical stimulation of nerve cells plus the original toxicological effect will cause accelerated degeneration and death of the neurons. The disease develops quickly during the later stages.
Any brain surgery is an invasive treatment with potential dangers, which a patient should thoroughly discuss with the medical team. Adverse effects range from postoperative headache and confusion to more serious perils, including:
· Stroke. The main risk in DBS surgery (or pallidotomy) is that about 2 out of 100 patients develop a stroke from bleeding in the brain, usually during or soon after the operation, says Starr. Mild weakness, numbness, or problems with vision or slurred speech may result. One in 100 patients have a severe stroke causing death or major permanent disability.
· Infection. With DBS surgery, the second most important risk is infection, which is usually not life-threatening. At UCSF and other brain surgery centers with considerable experience in this procedure, about 4 to 5 out of 100 patients suffer from serious infection that requires returning to the operating room to remove some or all of the device's components.
· Cognitive effects. Some patients experience depression, apathy, and impulsiveness after the surgery. DBS can also sometimes cause mild worsening in memory, thinking, and verbal fluency. These cognitive and behavioral effects tend to arise in older patients or who already had cognitive problems presurgery.
· Stimulation side effects. DBS can cause slurring of speech, blurred vision, and tingling or numbness in the skin, but these effects may lessen with adjustments to the neurostimulator.
· Hardware complications. Parts of the device may eventually erode or break through the skin. The risk of this occurring rises at a rate of about 1 percent for each year of use, says Starr. After 10 to 15 years, it's likely that some component of the DBS system will stop working and need replacing. (The battery runs down after two to five years and must be replaced.)
DBS has shown promise in reducing tremors and other symptoms of PD. However, some people who have undergone this procedure report putting on weight months after the surgery. There is concern that this added weight could induce a metabolic disorder such as diabetes. Although the underlying cause for the weight change is still unknown, many experts believe that the electrical currents the device emits may be spreading to a location of the brain called the hypothalamic center. That region controls appetite and signals satiety. Interestingly, some people with PD have reported carbohydrate cravings following DBS surgery. However, it’s important to note that in past studies approximately 20 percent of people who underwent this procedure actually lost weight.
For a quick look: http://www.apdaparkinson.org/uploads/files/APDA1602-DBS-factsheet-V3-Kq0.pdf
American Parkinson's Disease Association 2016
-------------------
7th June 2017
New research WIRELESS DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE
Deep brain stimulation (DBS) is the most commonly performed and most effective surgery for Parkinson's Disease but is unaffordable to a lot of people. It involves the use of electrodes implanted into the brain connected to an electrical device. For more information go to : www.ninds.nih.gov/Disorders/All-Disorders/Deep-Brain-Stimulation-Parkinsons-Disease-Information-Page
A novel wireless method of administering brain stimulation has been introduced that requires no implants or external connections. By injecting magnetic nanoparticles into the brain, neurons can be manipulated by applying external magnetic fields. These particles are capable of deep penetration of brain tissue and can stimulate nerve cells.
LATEST NEWS: 5 June 2018
http://www.viartis.net/parkinsons.disease/news/180605.pdf
= == = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = =
The risks of brain surgery for Parkinson's disease
Stereotactic Technique of Deep Brain Stimulation (DBS):
DBS requires the use of the opening cranium operation in order to implant the stimulated electrodes by using the CRW stereotactic heads, after a three dimensional image has been viewed by the computer, the coordinates of the nervous nuclei can be determined.
The purpose of the DBS pulse generator is to stimulate the functional dopaminergic neurons to release more dopamine in order to relieve the symptoms.
The advantages include lessening the amount of the dosage of dopamine medication and to improve the patient´s quality of life.
The disadvantages include a limited amount of effective time for the curative effect and the patient can only undergo the operation one time. Long-term electrical stimulation of nerve cells plus the original toxicological effect will cause accelerated degeneration and death of the neurons. The disease develops quickly during the later stages.
Any brain surgery is an invasive treatment with potential dangers, which a patient should thoroughly discuss with the medical team. Adverse effects range from postoperative headache and confusion to more serious perils, including:
· Stroke. The main risk in DBS surgery (or pallidotomy) is that about 2 out of 100 patients develop a stroke from bleeding in the brain, usually during or soon after the operation, says Starr. Mild weakness, numbness, or problems with vision or slurred speech may result. One in 100 patients have a severe stroke causing death or major permanent disability.
· Infection. With DBS surgery, the second most important risk is infection, which is usually not life-threatening. At UCSF and other brain surgery centers with considerable experience in this procedure, about 4 to 5 out of 100 patients suffer from serious infection that requires returning to the operating room to remove some or all of the device's components.
· Cognitive effects. Some patients experience depression, apathy, and impulsiveness after the surgery. DBS can also sometimes cause mild worsening in memory, thinking, and verbal fluency. These cognitive and behavioral effects tend to arise in older patients or who already had cognitive problems presurgery.
· Stimulation side effects. DBS can cause slurring of speech, blurred vision, and tingling or numbness in the skin, but these effects may lessen with adjustments to the neurostimulator.
· Hardware complications. Parts of the device may eventually erode or break through the skin. The risk of this occurring rises at a rate of about 1 percent for each year of use, says Starr. After 10 to 15 years, it's likely that some component of the DBS system will stop working and need replacing. (The battery runs down after two to five years and must be replaced.)
DBS has shown promise in reducing tremors and other symptoms of PD. However, some people who have undergone this procedure report putting on weight months after the surgery. There is concern that this added weight could induce a metabolic disorder such as diabetes. Although the underlying cause for the weight change is still unknown, many experts believe that the electrical currents the device emits may be spreading to a location of the brain called the hypothalamic center. That region controls appetite and signals satiety. Interestingly, some people with PD have reported carbohydrate cravings following DBS surgery. However, it’s important to note that in past studies approximately 20 percent of people who underwent this procedure actually lost weight.
For a quick look: http://www.apdaparkinson.org/uploads/files/APDA1602-DBS-factsheet-V3-Kq0.pdf
American Parkinson's Disease Association 2016
-------------------
7th June 2017
New research WIRELESS DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE
Deep brain stimulation (DBS) is the most commonly performed and most effective surgery for Parkinson's Disease but is unaffordable to a lot of people. It involves the use of electrodes implanted into the brain connected to an electrical device. For more information go to : www.ninds.nih.gov/Disorders/All-Disorders/Deep-Brain-Stimulation-Parkinsons-Disease-Information-Page
A novel wireless method of administering brain stimulation has been introduced that requires no implants or external connections. By injecting magnetic nanoparticles into the brain, neurons can be manipulated by applying external magnetic fields. These particles are capable of deep penetration of brain tissue and can stimulate nerve cells.