Subodh Prabhu & Neurosciences

Neurosciences ,Functional Neurosurgery ,Deep Brain Stimulation ,Indian Philosophy

Deep Brain Stimulation  some information

DBS (deep brain stimulation )


DBS is a modality of treatment of neurological diseases for which there are not many satisfactory drugs available at least today.DBS for Parkinson's Disease was first performed  here in Grenoble by Hon .Prof.Dr Alim Benabid. .He pioneered the  DBS in the world.

 DBS involves stimulation of specific areas of brain with High frequency current.The system contains depth electrodes ,a  programmable stimulator  and its battery

The putative mechanism with which DBS helps in clinical relief can be enumerated below

  DBS as a ‘information processing’ modulator

To borrow the terminology from the computer sciences ,the pathology can be summarized as network dysfunction

a)in ‘normal’ state there is very little synchronicity and pathological rhythms if generated are not synchronized over distant region

b)in diseased state the pathological rhythms are synchronized over a distance .the information and sequential processing of input is altered due to miscued signals from these pathological rhythms.

c)High frequency DBS acts as a ‘barrier è white noise’ and the information carried by pathological rhythms is not used for subsequent processing

 

Other  mechanisms with which DBS produces clinical benefit might be occurring at cellular and microscopic levels. These effects are postulated as basis for long term benefits seen in DBS and effects seen even after  the DBS is turned off;

 DBS might affect  gene  expression 

the turning on and  of gene could be affected

The gene responsible for programmed  cell death signal(often changed in neurodegenerative disorders) and apoptosis might be getting switched off ;

Production of neuroprotective molecules could be getting altered ;

 At synaptic level the DBS might be involved in

 augmentation of inhibitory or excitatory conduction

long term potentiation of synapse

Antidromic stimulation of the cell body

Changes in neurotransmitter  synthesis  and release .

 

The horizons are broadening ''''....

From the initial use in Tremor Predominant Parkinson's Disease the application of DBS has expanded and now covers other movement disorders ,neuropsychiatric diseases showing suboptimal response /resistant to current drugs ,Epilepsy ,Obesity and neuroprotection .

 

 

 

 

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