Neurological disorders are some of the most challenging for physicians and devastating for patients. Not only are they usually degenerative, but there is also no cure for most of them. Little is known about the brain, but research is underway to learn more and find cures to neurological diseases. Some of these disorders include those that lead to involuntary muscle movement, such as Parkinson’s disease or epilepsy, while others are classified as psychiatric disorders, such as depression or obsessive-compulsive disorder. Historically, the treatments used have been highly invasive, often further injuring the damaged part of the brain. Nowadays as neurotechnology advances, there are less invasive methods such as Deep Brain Stimulation (DBS), that have shown effectiveness in reducing symptoms in movement disorders. Let’s explore what deep brain stimulation is, how this treatment is administered to patients, and the ethics behind it.
Deep brain stimulation is delivered through a thin electrode that is inserted deep into the brain, delivering a timely pulsed electric current that supersedes the erratic pulses caused by the brain.The device is able to regulate the pulses through a pacemaker that is inserted right below the clavicle. An advantage of DBS is that the electrodes are surgically implanted while the patient is conscious, thus its effectiveness can be tested right after its placement. There is a more sophisticated and effective electrode being investigated that, if successful, could detect when a new seizure is about to occur by identifying abnormal electrical brain impulses. Hence, instead of emitting a constant pulse, the device would be able to send a regulating signal to the area of the brain where the seizure is about to happen. In addition, if a patient is not content with the results of this treatment, it can be stalled by simply turning off the device.
In the 1960s, a pharmaceutical treatment was developed to treat Parkinson’s disease. Since patients with Parkinson’s showed a decrease of the neurotransmitter dopamine in the basal ganglia (the part of the brain associated with movement) and in urine, researchers thought that an appropriate course of treatment would be to provide the dopamine that the patients were lacking. A dopamine agonist (a substance that mimics the action of dopamine) named L-dopa was synthesized to fill this purpose. This is still considered the most effective pharmaceutical treatment for Parkinson’s disease. However, its drastic side effects show the importance of finding a more targeted alternative. Patients treated with L-dopa in the long term have shown increased levels of toxicity and inflammatory responses. Similar adverse impacts are common among pharmaceutical treatments for neurological disorders. Thus, researchers are developing other treatments, such a DBS, that will be more efficient and that lead to less severe side effects.
For now, DBS has only been used to treat movement neurological disorders, however, researchers are investigating its possible use in treating psychiatric disorders such as depression, anxiety, or obsessive-compulsive disorder. In this context, DBS would not be used to deliver pulses marked by a pacemaker. Instead, it would interrupt erratic connections between different parts of the brain that cause the symptoms, such as the frontal lobe and the amygdala (a part of the brain associated with emotions). Treatments like DBS are less invasive, more efficient, and more precise, as they aim to target the specific part of the brain involved in causing the symptoms.
As with all types of medical practices that interfere with the brain, there are components of DBS that must be considered with caution. It is important to note that this device’s precision is not 100%, as there is not a specific part of the brain that causes each mood and personality disorders. In addition, the risk of causing unwanted damage to other brain functions still exists and the surgery through which the DBS electrode is placed could unintentionally lead to the damaging of other parts of the brain. It is crucial that the treatment is delivered consensually and that every patient is informed of the possible side effects, such as mood shifts, that could result from the treatment. Ethical and legal regulations, as well as other treatment options, are important to mitigate negative impacts of DBS. With more research and advancements, DBS has the potential to aid both movement and psychiatric neurological disorders. As long as this treatment is supplied with informed consent and patients are advised of its possible physical and mental side effects, DBS could be a highly successful treatment for brain diseases.