Pondering the Brain-Stimulating Possibilities

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I have a special place in my heart for the brain. This intricate, powerful and mysterious 3-pound organ nestled inside our heads is the source of everything we know, feel and do, consciously and otherwise. It’s also the most poorly understood part of the body – by a long shot.

And that makes it all the more exciting to learn about the pioneering advances made in neuroscience and psychology. These advances can provide a deeper understanding of ourselves, our family, our friends and our world. They can also provide hope: to prevent, change, treat, improve or even cure countless devastating disorders stemming from some abnormal behavior in the brain.

Promising possibilities may lie in deep brain stimulation –  a surgical technique that uses an implanted pacemaker to stimulate highly specific parts of the brain affected by a disorder. DBS has already improved the lives of thousands of people with motor disorders, including Parkinson’s disease and tremors.

Now recent research is yielding similar results in patients suffering from epilepsy, depression, obsessive-compulsive disorder, chronic pain and other debilitating conditions. In the first large, double-blind study of its kind, for example, epilepsy patients undergoing deep brain stimulation had a significant reduction in seizures. In another study, more than half the participants – who suffered from severe, long-term depression unresponsive to any other treatments – felt considerably better with DBS treatment.

In reviewing recent research and talking with various neuroscientists about deep brain stimulation, I quickly realized that the potential of this treatment is – well, mind-boggling.

“Wait, wait, wait – the FDA will likely approve this treatment for depression in epilepsy in the next decade?” I remember repeating back to one neurophysiologist during an interview to confirm what I had just heard. “It could possibly treat Alzheimer’s or obesity one day? What’d you say about ADHD?!”

The more I learn about deep brain stimulation, the more surprised I am at how rarely it is mentioned in the media or elsewhere. Researchers and medical professionals seem excited about it. Most experts on the topic agree that, when done correctly, it can be an effective solution where nothing else has worked. They also agree that, based on the positive research thus far, DBS is en route to becoming a common and effective treatment option for various disorders affecting millions of people.

It is, however, still in its experimental stages. The FDA requires a substantial amount of evidence to approve its use for a disorder, and it’s currently only approved for Parkinson’s and essential tremors. In order to cross the threshold from experimental technology to widespread application, several bigger studies with positive results are needed.

Perhaps the medical community and media are waiting for some of these larger, supporting studies before stirring emotions on a world stage. But at this point, many people have never even heard of deep brain stimulation. Even worse, some unfairly liken it to a futuristic form of lobotomy and electroshock therapy.

Patients undergoing DBS treatment first have electrodes surgically implanted on to a highly specific part of the brain (usually no bigger than a thumbnail) affected by the disorder. The electrodes, wired to a pacemaker implanted near the collarbone, then provide an ongoing, externally adjustable electrical current to the brain region for a period ranging from a few months to several years. The continued stimulation of the malfunctioning brain region modifies brain circuitry and stabilizes the affected region, experts believe.

The brain uses electricity to function, Chicago neurosurgeon Dr. Roy Bakay explained to me. “DBS is a manual electrical system that can control the brain’s electrical system,” he said. “It’s not as though this is some strange and sundry phenomenon: It makes sense.”

And it does. And I suspect it will make more and more sense as neuroscientists further unravel the mysteries of the brain.

- blog authored by Daniel Peake

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