Deep brain stimulation is a neurosurgical approach that involves the use of brain-implanted electrodes to treat a variety of neurological and psychiatric conditions. In this video, I discuss the uses, general procedure, and hypothesized mechanisms of deep brain stimulation.
TRANSCRIPT:
Deep brain stimulation is a neurosurgical approach that involves the use of brain-implanted electrodes to treat a variety of neurological and psychiatric conditions. It is primarily used to treat movement disorders like Parkinson’s disease, but has also been approved by the FDA for use in treating epilepsy and obsessive-compulsive disorder, and is being studied as a potential treatment for a number of other disorders like chronic pain and depression.
Deep brain stimulation involves the insertion of an electrode into the brain. The electrode is connected to a wire that runs under the skin to a device called a pulse generator, which is usually implanted under the collar bone. When the pulse generator is turned on, it emits electrical impulses that alter neural functioning. In Parkinson’s disease, for example, the electrode is typically placed near structures like the subthalamic nucleus, whose overactivity in the disease is thought to contribute to movement problems like difficulty initiating movement. Modifying the activity of these overly excitable regions can alleviate the symptoms of Parkinson’s disease. It should be noted, however, that deep brain stimulation is major brain surgery, and thus there are risks associated with the procedure.
Despite numerous studies that have investigated the mechanism of deep brain stimulation, there is still a lack of clarity as to how the treatment leads to beneficial effects. Several hypotheses have been proposed to explain the mechanism, and they are not necessarily mutually exclusive. For example, deep brain stimulation may inhibit action potentials by causing prolonged depolarization of neuronal membranes, reduce neuronal activity by prompting the release of inhibitory neurotransmitters like GABA, and disrupt abnormal rhythmic neuronal firing that might interfere with healthy brain function. But more research needs to be done to develop a clear understanding of the effects of this treatment on the brain.
REFERENCES:
Aum DJ, Tierney TS. Deep brain stimulation: foundations and future trends. Front Biosci (Landmark Ed). 2018 Jan 1;23:162-182. doi: 10.2741/4586. PMID: 28930542.
Herrington TM, Cheng JJ, Eskandar EN. Mechanisms of deep brain stimulation. J Neurophysiol. 2016 Jan 1;115(1):19-38. doi: 10.1152/jn.00281.2015. Epub 2015 Oct 28. Erratum in: J Neurophysiol. 2020 Mar 1;123(3):1277. PMID: 26510756; PMCID: PMC4760496.
