Neuroscience has shown considerable advancement in recent times. Deep brain stimulation is a technique used by doctors to cure neurological disorders such as Parkinson’s disease. Successful cases of deep brain stimulation surgeries have been reported from different parts of the world. DBS surgery cost depends on various factors that we will discuss in detail.
Before we delve into the causes, procedures, and costs of deep brain surgery, let us clearly understand what the surgery is. Deep brain stimulation is a procedure that involves implanting electrodes in certain targeted areas of the brain. These electrodes further generate electric impulses with the help of a device implanted under the skin and help block or change the abnormal activity causing various symptoms of the disease.
The procedure of Deep brain stimulation consists of four parts:
- Thin insulated wires called leads that end in electrodes and are implanted in targeted areas of the brain.
- A pulse generator which is similar to a pacemaker used in heart patients generates electrical impulses.
- Extension leads that connect the pulse-generator device to the leads implanted in the brain. Electrical impulses are carried from the device to the leads through these extension leads.
- A hand-held programmer device that can be used to adjust the device’s signals and also to turn the device on or off.
During deep brain stimulation surgery, the electrodes and the pulse generator are implanted in the patient’s body. Once these are activated, the pulse-generator sends continuous electrical signals to the specific areas in the brain. These impulses modify the abnormal signals being generated in these areas of the brain, thus reducing the symptoms. The working of the deep brain stimulation system is similar to the pacemaker used during cardiac procedures and thus is sometimes referred to as the pacemaker of the brain.
Which type of health conditions can be treated with deep brain stimulation?
Deep brain stimulation is approved by the FDA to treat a variety of neurological disorders. These are:
- Compulsive-obsessive disorder
- Parkinson’s disease
- Involuntary tremors
- Multiple sclerosis
- Tourette syndrome
- Anorexia nervosa
- Alzheimer’s disease
- Stroke recovery
- Thalamic pain syndrome
What is the procedure of Deep brain stimulation surgery?
Deep brain surgery is performed under general anesthesia. Before beginning the surgery, a stereotactic head frame is placed around your head. Its main function is to keep your head still during brain imaging and other procedures. The frame is screwed to your head with the help of surgical pins or screws.
The deep brain stimulation system is implanted in two steps by the neurosurgeon.
First of all, a small hole is made in the skull, through which leads are inserted inside. These leads have small electrodes at the end and are implanted in the targeted areas of the brain. A lead is then positioned at one side of the brain if the symptoms are visible on one side. In case symptoms are visible on both sides, then leads are positioned on both sides of the brain. Each hemisphere of the brain controls the opposite side of the body, so the leads are positioned accordingly.
One week after this procedure, a separate operation is performed wherein one or two battery-powered pulse generators are implanted under the skin under the collarbone. An extension lead is attached to the lead inserted in the brain, tucked behind the ear under the skin, and tunneled down the neck to the pulse generator device.
The implanted pulse generator can be operated by a hand-held device. The generator can be switched on and off to adjust according to the body’s requirement until the symptoms show some visible improvement. The battery level can also be checked by the hand-held device.
You need to visit the doctor after two to four weeks of implant for a check-up. If everything is fine, the pulse generator is switched on by the hand-held device and the electrical impulses are adjusted according to the patient’s need. The stimulation sent to the brain is fine-tuned in several follow-up sessions. The frequency of the follow-up sessions varies from patient to patient. The doctors schedule long-term regular follow-up sessions to ensure that everything is working perfectly and the patient does not show any adverse complications.
What are the advantages of deep brain stimulation?
The major advantage of the deep brain stimulation procedure is that it does not cause any permanent damage to the brain and so is considered to be low-risk surgery. Moreover, the electrical impulses generated are adjustable as per need and can be reversed as the person’s response to the medication changes. As this treatment is reversible, other innovative methods that may be available in near future can be tried on the patient. In case the stimulator shows some unwanted response, it can immediately be switched off by the hand-held device.
Every surgical procedure is associated with certain risks and complications that may or may not occur. The doctor is the right person to decide whether this procedure of deep brain surgery will be beneficial for you.