Deep Brain Stimulation (DBS) [Neurosurgery Wiki]

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====== Deep Brain Stimulation (DBS) ======

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Deep Brain Stimulation (DBS) is a neurosurgical technique that delivers electrical impulses to specific brain areas to treat movement and psychiatric disorders.
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===== Definition =====
DBS involves the implantation of electrodes into targeted brain regions. These electrodes are connected to a pulse generator (IPG) placed subcutaneously, usually in the chest. Electrical stimulation modulates abnormal neural activity.

===== How It Works =====
  * Electrodes are implanted in deep brain structures (e.g., STN, GPi, VIM)
  * Leads are tunneled under the skin and connected to a pulse generator
  * Electrical pulses are delivered continuously or in cycles
  * Stimulation parameters can be adjusted noninvasively

===== Approved Indications =====
  * [[Parkinson’s Disease]]
  * [[Essential Tremor]]
  * [[Dystonia]]
  * [[Obsessive-Compulsive Disorder]] (OCD)
  * [[Epilepsy]]

===== Experimental / Emerging Indications =====
  * Major Depression
  * Tourette Syndrome
  * Alzheimer’s Disease
  * Chronic Pain
  * Addiction

===== Benefits =====
  * Reduces motor and psychiatric symptoms
  * Adjustable and reversible
  * May reduce the need for medication
  * Improves quality of life in selected patients

===== Risks =====
  * Infection
  * Hemorrhage
  * Hardware-related complications
  * Neuropsychiatric effects (e.g., apathy, impulsivity, mood changes)

===== Common Targets by Indication =====

^ Condition              ^ Target Brain Area                        ^
| Parkinson’s Disease    | Subthalamic Nucleus (STN)               |
| Essential Tremor       | Ventral Intermediate Nucleus (VIM)     |
| Dystonia               | Globus Pallidus Internus (GPi)         |
| OCD                    | Nucleus Accumbens, VC/VS               |

===== Future Directions =====
  * Adaptive DBS (aDBS) with real-time feedback loops
  * Imaging-guided targeting and connectomics
  * Expanded indications through clinical trials
  * Integration with wearable tech and AI-based stimulation control

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''DBS is one of the most impactful neurosurgical advances in functional and psychiatric neurosurgery.''
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