Have you met the DBS Technology?

Deep Brain Stimulators are devices that enable us to deliver electrical current to any point in the human brain, thus stimulating or suppressing the electrical activity in the brain cells in the area where the electrical current is applied. We can successfully treat Parkinson's disease as well as movement disorders such as essential tremor and dystonia using this treatment method known as "neuromodulation." DBS is a device placed inside the human brain, consisting of an electrode with four polarity-variable platinum-iridium poles, an extension that connects this electrode to the main battery device, and the body of the DBS. The electrode part of the DBS is placed inside the human brain. This electrode is integrated into the battery placed under the skin on the upper part of the rib cage by means of an extension. This battery device, which can be programmed with an external computer, enables the four poles at the end of the electrode to be changed as positive, negative, or neutral, and to produce alternative combinations. In addition, the intensity of the electric current to be given to the brain, the number of waves given per second, and the wave width are adjustable.

How are the Positions of the Target Cells Found?

In these surgeries, we find an anatomical formation with a diameter of 2-3 millimeters in the brain and intervene there. The safest method, which ensures that the results are very pleasing and the low risks, that is, "ensure the right intervention in the right place," is the "Microelectrode Recording and Stimulation Technique." Thanks to this technique, we can listen to the cells responsible for the disease in the brain one by one and determine their correct locations. This technology brings us to our goal, and thanks to this technique, we can draw the physiological map of the brain. We place DBS electrodes on the diseased area, which we detected with an error margin of less than 80 microns.

Why Is The Patient Awake During Surgery?

During most of the operation, the patient is awake and talking to us and we’re chatting with each other. Sometimes they talk about their grandchildren, sometimes they chat about football and sometimes they sing a song. The purpose of keeping the patient awake during surgery is to locate the cells responsible for the disease and the anatomical formations around it. For this reason, we perform the surgery while the patient is awake and talking. In this way, it is easier to reach the problematic area by measuring the patient's reactions.

What is the Technological Life-time of DBS?

Until recently, we used non-rechargeable batteries, and the lifespan of DBS in Parkinson's patients was between 4-6 years. This period may be even shorter in dystonia patients who require higher electrical current. Thanks to the developing technology in recent years, it is possible to apply batteries that can be charged externally and have a life-time of up to 20-25 years; also we have started to use devices with technology that can adjust the direction and intensity of the electric current we inject into the brain as we want. Thanks to these developments, our success rates in treatment have increased. On the other hand, there has been no need for battery replacement for a long time.

The Importance and Function of the DBS

We can define DBS surgeries as "turning back the clock of the disease". We can return a ten years Parkinson's patient back to the early years of her/his disease.We do not eliminate the disease, but significantly improve the motor manifestations of it. Thanks to this treatment, people who cannot live independently and who are disconnected from social life have the chance to live independently again, and a significant number of them have the chance to practice their profession again.

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