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Deep Brain Stimulation for Parkinson's Disease: Advantages, Challenges, and Future Prospects

Discover the background of Parkinson's disease, explore modern treatments like deep brain stimulation (DBS), learn about DBS mechanism, electrode implantation, advantages, disadvantages, candidacy requirements, limitations, and future developments in personalized medicine. Find out how DBS reduces motor symptoms, improves gait and tremor, and may reduce medication dependency.

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Deep Brain Stimulation for Parkinson's Disease: Advantages, Challenges, and Future Prospects

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  1. Deep Brain Stimulation For parkinson’s disease Jake Morris

  2. Background • Parkinson’s Disease • Neurodegenerative disorder caused by the death of dopamine-generating cells in the substantia nigra • Prevalence • 1.5-2.0% of people age 60 or older • Symptoms • Tremors, impaired gait, loss of balance, bradykinesia Repetitive “pill rolling” movement Persistent Tremors Shuffling gait, taking small steps

  3. Modern Treatments • Levodopa • Dopamine Agonists • Surgery (Deep Brain Stimulation)

  4. Brief history

  5. What is deep brain stimulation? • Mechanism • High frequency pulses sent to specific areas of the brain • Components • Lead, implantable pulse generate, electrode • Uses • Parkinson’s Disease • Tourette’s Syndrome • Chronic Pain • Major Depression Electrode Brain Implant Generators

  6. Different dbs insertions • Reduces motor symptoms, improves gait, tremor, and bradykinesia • Reduces all of the major motor manifestions of PD, painful cramps and sensory symptoms, and dopa-induced dyskinesias • Reduces limb tremor

  7. Advantages and disadvantages of dbs Pros Cons Simple cognitive tasks may be improved but difficult tasks may be impaired Emotional awareness/identification May induce manic responses, hallucinations, and decreased mood or act as an antidepressant Selective candidacy DBS may exacerbate cognitive impairments i.e. disorientation or memory deficits • Reduces time a patient spends in the ‘off’ state when medication benefits diminish • Off state leaves patients slow, shaky, stiff, and unable to rise from a chair • Permits reduction of medications and their adverse side effects

  8. Candidacy requirements • Short duration of benefit from individual doses of levodopa • Substantial motor benefit from oral medication • Limited by dopa-induced side effects

  9. Limitations • Exact mechanism still unknown for DBS • Only alleviates symptoms, does not act as a cure • Surgical complications, risk of infection • Not beneficial to all patients suffering from PD

  10. Future • Personalized medicine in which clinicians choose targets and approaches for specific symptoms in an individual patient. • Smaller hardware • Placement of pulse generator in chest to disappear • More leads and targets per patient • Leads coated to reduce chance for infection • Remotely monitor and control devices • Patients given access to their electrical settings, ability to “tune” themselves

  11. Works cited • Breit, Sorin, JöRg B. Schulz, and Alim-Louis Benabid. "Deep Brain Stimulation." Cell and Tissue Research 318.1 (2004): 275-88. Web. 27 Sept. 2014. • "Deep Brain Stimulation for Parkinson's Disease Patients." WebMD. WebMD. Web. 28 Sept. 2014. • "Deep Brain Stimulation." National Parkinson Foundation -. Web. 27 Sept. 2014. • "Deep-Brain Stimulation for Parkinson's Disease." New England Journal of Medicine 368.5 (2013): 482-84. Web. 27 Sept. 2014. • "Parkinson's Disease." Wikipedia. Wikimedia Foundation, 26 Sept. 2014. Web. 28 Sept. 2014. • Perlmutter, Joel S., and Jonathan W. Mink. "Deep Brain Stimulation." Annual Review of Neuroscience 29.1 (2006): 229-57. Web. 26 Sept. 2014.

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