DBS Flashcards
What is deep brain stimulation (DBS)?
The use of fine wire implants in certain brain regions triggered by a subdermal pacemaker device.
What is the purpose of high-frequency electrical stimulation in DBS?
To temporarily ‘arrest’ the activity of the brain region.
List some indications for DBS.
- Parkinson’s disease
- Essential tremor
- Tourette’s disorder
- Dystonia
- Major depression
- Obsessive-compulsive disorder (OCD)
- Chronic pain (neuropathic and phantom limb pain)
Which brain regions are primarily targeted for DBS in Parkinson’s disease?
- Subthalamic nucleus
- Internal globus pallidus
What advantage does DBS have over ablative surgery?
Less invasive, can be turned off when not required, and wires can be easily removed.
What are some surgical complications associated with DBS?
- Infection (0–15%)
- Intracranial haemorrhage (0–4.5%)
- Stroke (0–2%)
- Lead erosion
- Lead fracture
- Lead migration
- Death (0–4.4%)
What is the most common surgical complication of DBS?
Infection
What is the reported incidence of postoperative seizures after DBS?
Varied from 0% to 4%, approximately 2% on average.
What neuropsychiatric side effects can occur with DBS?
- Depression
- Anxiety
- Mania
- Impulsivity
- Impulse control disorders
- Speech and language difficulties
- Decreases in cognitive performance
- Postural instability with increased falls
What is the reported postoperative incidence of depression with DBS according to a recent literature review?
1.5%–25%
True or False: DBS has been found to be as effective as medications for Parkinson’s disease without motor side effects.
True
DBS of the internal capsule has shown positive effects for which condition?
Obsessive-compulsive disorder (OCD)
DBS can reduce abnormal movements in patients with which disorder?
Tourette’s disorder
Fill in the blank: DBS can also be used for chronic pain, including _______.
[neuropathic and phantom limb pain]
What is the risk of epilepsy associated with DBS?
Essentially nil
