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Deep Brain Stimulation Revolutionizes Treatment

ILLUSTRATION: Deep Brain Stimulation

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In the summer of 2011, when U.S. resident Yoheved Hasson began feeling involuntary shaking in her left leg, she soon learned from a local neurologist that she had Parkinson’s disease. Several years later, after trying prescription medications and other treatments to no avail, she was told by doctors that her only hope for recovery was an experimental procedure called deep brain stimulation. Using this method, doctors would attempt to surgically reach into the part of her brain that had triggered the Parkinson’s and deliver an electrical impulse to change the course of the illness and return Hasson to normal.

“I was nervous, but my doctor told me it was the only option we had left,” Hasson said.

Her treatment was performed at Cedars-Sinai Medical Center in Los Angeles – and, so far, she has been free of any sign of Parkinson’s. But if brain stimulation might be an option to help you recover from Parkinson’s or another chronic illness, you don’t have to go all the way to the West Coast. At the Medical University of South Carolina in Charleston, researchers not only run the state’s only comprehensive brain stimulation center, they continue to pioneer efforts to help people like Hasson overcome Parkinson’s and an array of other illnesses and mental health conditions.

“Brain stimulation is revolutionary in psychiatric care,” said Edward Baron Short, M.D., director of the Brain Stimulation Service at MUSC. “And as treatments are starting to spread throughout South Carolina, MUSC remains the top in expertise and innovation for brain stimulation care.”

For example, MUSC physicians were the first to use a variety of brain stimulation treatments for depression, obsessive compulsive disorder and smoking cessation. Other illnesses that have been treated with brain stimulation include epilepsy, essential tremor, chronic pain, dystonia, Tourette’s syndrome and a number of psychiatric conditions.

“Depression is the biggest need,” Dr. Short said. “1 in 5 people are suffering from depression or mood disorder, and we have several brain stimulation methods available for their treatment.”

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These treatment methods include:

  • Transcranial magnetic stimulation. TMS uses magnetic fields to stimulate specific brain regions, such as the prefrontal cortex, that are commonly underactive in people suffering from a variety of disorders. Patients usually need six weeks of daily individual treatment. Each session lasts 20 minutes, and people start to feel the benefits within a few weeks.
  • Electroconvulsive therapy. With roots to the 1930s, ECT involves the controlled induction of a brief seizure through electrical currents applied to the brain. Individual treatment, unique to a patient’s system and level of need, is provided three times a week for three to four weeks.“Patients go home within an hour of ECT treatment,” Dr. Short said. “And about 75% of severely depressed patients find ECT tremendously improves their condition.”
  • Vagus nerve stimulation. Long used to treat epileptic seizures, VNS utilizes an implanted device under the skin that sends electrical pulses to one side of the vagus nerve, one of the 12 cranial nerves in the body. Because this large nerve carries messages to areas of the brain that regulate mood and sleep, it is implicated in depression, anxiety and other mental health conditions.“Most people feel nothing when the device delivers a pulse, which usually occurs once every five minutes,” Dr. Short said. “VNS was FDA-approved for adults with chronic recurring depression.”
  • Deep brain stimulation. DBS is an invasive, surgical therapy that involves implanting electrodes in specifically targeted brain areas during open brain surgery to modify disorders in signaling. When successful, this method can relieve sufferers like Hasson from movement disorders such as Parkinson’s disease and essential tremor.

Dr. Short said, however, that while all of these methods represent light-year advancements toward curing a host of human illnesses, “the research is only at the beginning.”

“DBS does not fully resolve the symptoms of Parkinson’s or other conditions,” he said. “But it can decrease a patient’s need for medications and improve quality of life.”

So far, based on estimates by the National Institutes of Health, more than 160,000 patients worldwide have undergone DBS for a variety of neurological and non-neurological conditions. And with Hasson as a prime example, those numbers – and DBS treatments – are likely to be the wave of a very near future.

“Do not be afraid of deep brain stimulation,” Hasson said. “It is a life-changing procedure.”
Sketched illustration of brain stimulation

By L. C. Leach III

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