After having proven itself in Parkinson’s disease, deep brain stimulation or DBS in English (for “Deep Brain Stimulation”) is a technology that offers new avenues for treating severe forms of OCD (obsessive-compulsive disorder), neuromuscular disorders and major depression.
Operating the brain on an awake patient can be scary! Wrongly, however. Far from the lobotomies of yesterday, deep brain stimulation is now well mastered. Well established in Parkinson’s disease, it corrects motor symptoms such as tremors, stiffness and slowness of movement.
Deep brain stimulation (DCS): electrodes to stimulate the brain
Deep brain stimulation (DBS) is a surgical technique developed in France at the end of the 1980s by the team of Professors Alim-Louis Benabid (neurosurgeon) and Pierre Pollak (neurologist) at the Grenoble University Hospital.
DBS consists of permanently stimulating an area buried deep in the brain, more precisely the subthalamic nucleus. For this, one to four very fine electrodes are surgically implanted there through a small hole, without opening the cranial box. The operation lasts between four and six hours.
An ultra-thin cable located under the skin connects the electrodes to a pacemaker-type device also placed under the skin, at the level of the collarbone. The latter produces an electric current, delivering high-frequency pulses to the electrodes. These can then stimulate the region of the brain involved in the onset of disorders.
Today, 60,000 patients have already benefited from this treatment worldwide. In France, 22 centers regularly implant deep brain stimulation electrodes (Source 1).
Deep brain stimulation: a surgery performed on awake patients
Most Most of the 22 hospital teams performing this cutting-edge neurosurgery today do it on awake patients: “Their ‘live’ feedback allows us to very precisely target the nerve cells to be excited”, explains Professor Pierre Pollak, neurologist at the Grenoble University Hospital. The medical team asks for the patient’s collaboration to validate the correct positioning of the electrodes. Then you have to wait almost three months for the effect to stabilize.
But only 5% of patients can benefit from neurostimulation and 300 to 400 people are operated on each year. “They are young and exposed to motor complications with the L-dopa treatment”, explains Pr Pollak. Research is currently being carried out on other areas of the brain to be stimulated. Their objective: to reduce the motor disorders that occur at a more advanced phase of the disease, such as the blocking of walking.
