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BB2 > Deep Brain Stimulation > Flashcards

Deep Brain Stimulation Flashcards

1
Q

Deep brain stimulation

A

Stimulating electrodes placed surgically into deep brain structures and connected to implanted pulse generator

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2
Q

Which conditions is DBS funded for by the NHS

A

Parkinson’s
Essential tremor
Dystonia

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3
Q

Which conditions does the NHS fund DBS on a case by case basis

A

Epilepsy
Chronic neuropathic pain

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4
Q

Essential tremor

A

Brain disorder causing parts of body to tremor uncontrollably

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5
Q

Dystonia

A

Brain disorder with sustained or repetitive muscle contractions resulting in twisting and repetitive movements or abnormal fixed postures

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6
Q

Parkinson’s DBS criteria

A

Idiopathic PD
4 classical symtoms
No sensory issues, weakness, or hyperreflexia
No brain abnormalities/tumours
No mental disorders
Levodopa responsive
Fit for surgery
Realistic surgery expectation

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7
Q

Which PD symtoms can DBS treat

A

Motor

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8
Q

How is DBS electrode target site identified

A

MRI

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9
Q

How long between insertion and programming of electrode

A

1 month

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10
Q

Results of DBS in PD

A

Increase on time
Decr bradykinesia, rigidity, tremor
Decr drug doses needed

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11
Q

DBS targets for PD, tremor, and Dystonia

A

Zona incerta tremor
Subthalamic nucleus tremor
Globus pallidus internus tremor+Dystonia

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12
Q

DBS target for epilepsy

A

Anterior nucleus of thalamus

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13
Q

DBS target for theraoy refractory OCD

A

nucleus accumbens
Ventral striatum

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14
Q

Treatment resistant major depressive disorder DBS targets

A

Subcallosal cingluate - brodmann 25
Nucleus accumbens

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15
Q

Addiction DBS target

A

Nucleus accumbens

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16
Q

Is DBS reversible

A

Yes

17
Q

Is DBS long or short term treatment

A

Long term
24 hr control for years

18
Q

DBS risks

A

Brain haemorrhage
CSF leakage
Transplantation problems - infection, allergy to implant
Temporary tingling, balance loss, dizziness, concentration issues
Migration of electrode
Rebound when stimulus stopped
May not effect pt

19
Q

4 hypothesised DBS MOA

A

Inhibition hypothesis
Excitation hypothesis
Disruption hypothesis
Neuro network modulation hypothesis

20
Q

DBS inhibition hypothesis

A

DBS blocks spontaneous discharge of overactive neurones

21
Q

DBS excitation hypothesis

A

DBS excites afferent axons ‘jamming’ spontaneous neurone activity

22
Q

DBS disruption hypothesis

A

DBS disrupts abnormal information flow by dissociating inputs and outputs

23
Q

DBS Neuro network modulation hypothesis

A

DBS causes neuroplasticity

24
Q

How does DBS affect disease

A

Modify or slow progression
Cannot cure

BB2 (26 decks)

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