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Stimulation Cover story
Eases Symptoms for Patients with Some Movement Disorders
Deep-brain stimulation (DBS) functions
like a pacemaker to correct abnormal
patterns of brain activity for patients
with neurological disease.
DBS carries relatively minimal risk and
in most cases significantly improves the
patient’s quality of life.
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electrodes are strategically placed in the brain.
The pacemaker includes a chest-implanted
generator that sends continuous pulses. Just
as the heart pacemaker helps to correct an
abnormal heart rhythm, the brain pacemaker
uses these pulses to correct the abnormal
patterns of activity in the brain for patients with
neurological disease — easing the involuntary
movements characteristic of such conditions
as Parkinson’s disease and essential tremor.
DBS is most commonly performed as an asleep/
awake/asleep procedure: The patient is asleep
and anesthetized at the beginning of the surgery,
as a hole is being drilled in the skull; once the
potentially uncomfortable phase is over and the
brain is exposed, the patient is awakened and
asked to respond to verbal commands, providing
feedback to assist the surgical team in optimal
placement of the electrodes before being put to
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sleep again as the skull is closed up. Since there
are no pain receptors within the brain, patients
experience no discomfort while awake during
“This is a surgery whose goal is to improve
function and quality of life,” explains Dr.
Pouratian. “The best way to ensure that we are
achieving that goal is to actually test the patient
during surgery, when we first put the electrode
in, and make sure we’re getting the benefits from
the stimulation while limiting the side effects.
If it’s not in the optimal position, that’s our
opportunity to move the electrode.”
First approved by the U.S. Food and Drug
Administration (FDA) in the late 1990s, DBS
carries relatively minimal risk and, in most
cases, it significantly improves patients’ quality
of life. “This doesn’t change the underlying
disease,” Dr. Pouratian says. “It doesn’t change