Who better to comment on the recent Smithsonian Magazine article about Deep Brain Stimulation than two renowned neurosurgeons who specialize in this very subject: Dr. Guy McKhann and Dr. Sameer Sheth.
Deep Brain Stimulation (DBS) involves the placement of a tiny electrode inside the brain.
When turned on, the electrode can deliver an electrical charge that interrupts the normal flow of information in the brain. This can help to decrease symptoms of a number of movement disorders such as Parkinson’s disease and dystonia, as well as certain psychiatric disorders such as PTSD and addiction.
The Smithsonian article, Inside the Science of an Amazing New Surgery Called Deep Brain Stimulation, offers great insight, and neurosurgeons, Dr. Sheth and Dr. McKhann from our Epilepsy Center and Movement Disorders Center had more to add. See their comments below.
Dr. Guy McKhann said:
“There are several interesting points. Teamwork between Movement Disorder Neurologists and Functional Neurosurgeons is critical to the patient selection and operative success of DBS surgeries for movement disorders including tremor, Parkinson’s Disease, and dystonia.
In many ways, functional neurosurgeons need to be ‘surgical neurologists’ to best care for these complex patients in multidisciplinary fashion. We are fortunate to have 15 years and hundreds of patients of expertise working with Dr. Blair Ford, the Movement Disorder Neurologist who directs our Movement Disorder Surgery Center, and with Dr. Seth Pullman and Dr. Qiping Yu, who carry out our intraoperative brain physiology monitoring.
Movement Disorders are just the first of many applications of DBS that will likely become part of everyday patient care. Applications to Psychiatric conditions include Obsessive Compulsive Disorder (OCD), which is FDA approved on a case by case basis, and Major Depression, which is under active study.
Dr. Sameer Sheth , together with faculty from the Columbia University Department of Psychiatry and the New York State Psychiatric Institute, is spearheading our work in psychiatric applications of DBS.
Additionally, DBS for epilepsy is already approved in Europe. DBS following head trauma to improve neurological recovery or to enhance memory in Alzheimer’s Disease are also active areas of human investigation.
While the analogy with cosmetic surgery as discussed in the Smithsonian article is tempting, DBS is a long way off from an elective surgery to try to “improve” function in humans who do not suffer from a disease process. Besides the obvious ethical issues, DBS placement is brain surgery, with the attendant albeit rare risks of major complications.”
Dr. Sameer Sheth said:
“In addition to the approval of DBS for epilepsy in Europe, DBS for OCD is also approved in most European countries. Additional neuropsychiatric disorders under investigation for treatment with DBS include PTSD, chronic pain, addictions, and eating disorders.
As we investigate the utility of DBS for these and other disorders, the multidisciplinary approach is critical. No one person alone can bring the necessary information to the table to determine which patients are appropriate candidates.
As Dr. McKhann said, it’s still brain surgery, and the decision to proceed should be made carefully, with as much information and expertise as possible.”
Learn more about Deep Brain Stimulation here and in our previous blog posts listed below:
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