DEEP BRAIN STIMULATION AND PARKINSON’S DISEASE

Source: https://www.a4clinics.com/single-post/2018/04/11/Early-Intense-Exercise-Delays-Parkinsons-Disease-Progression
Source: https://www.aiphc.com/methods-to-treat-parkinsons-disease/
  • Electrodes placed in the brain at sites of stimulation (roughly the size of a spaghetti strain).
  • A pulse generator (device implanted in the chest to deliver stimulation)
  • Thin insulated wires called leads that connect the electrodes and pulse generator
  • An external device used to turn on/off the pulse generator and adjust its frequency
Source: https://www.nejm.org/doi/full/10.1056/NEJMct1208070

THE FUTURE OF DBS

A modern implementation of DBS involves active feedback and adjustments caused by the implementation of biomarkers. The existence of these biomarkers such as electrophysical surrogates of Parkinson’s diseases’ motor signs allows for the implementation of adaptive algorithms. An expected increase in the recognition of biomarkers will allow for the efficacy of a closed-loop system of deep brain stimulation. Rather than be constantly reprogrammed based upon novel symptoms, a closed-loop system can actively slow and potentially prevent future symptoms through the recognition of faulty signaling. The applications of such a process can also be reactive such as triggering thalamic deep brain stimulation in the instances of epilepsy, seizures, or tremors. Current investigations such as the pattern hypothesis further expand research areas for potential breakthroughs to arise. It was found that movement disorders often stemmed from a variance in patterns of neuronal activity rather than changes in the rate. This opens up the potential for different ways in which stimulation is targeted within the brain as well as varying targets to utilize.

Source: https://www.ccjm.org/content/ccjom/75/3_suppl_2/S59.full.pdf

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