Improved Techniques for Deep Brain Stimulation

 

Dr, Kim Burchiel, the head of Neurosurgery at Oregon Health and Science University was the first surgeon to use the techniques for Deep Brain Stimulation (DBS) surgery in the United States more than 10 years ago.  Now he has refined the techniques making them even more accurate and improving the safety of the surgery for patients.

“This surgery allows for extremely accurate placement of the electrodes and it’s safer.  Plus patients don’t need to be awake during this surgery – which will mean many more patients who can be helped by this surgery will now be willing to consider it:” said Dr. Burchiel.

The new technique uses advances in medical imaging to improve the accuracy of the placement of the electrodes in the brain.  An MRI of the patient’s brain is obtained prior to the surgery and during the surgery a CT scan provides improved clarity for surgeons to eliminate any errors of placement.

DBS has been used in the United States for the last twenty years to help relieve some of the symptoms of Parkinson’s, such as tremor.  It is also used to treat some other neurodegenerative disease, such as familial tremor and dystonias.

DBS surgery places very thin electrical wires and electrodes into specific regions of the patient’s brain and then connects them to a pacemaker-like device implanted under the skin of the chest.  Surgery can last between four and six hours, and the patient is required to be awake to make sure the placement is accurate.  Many patients who might benefit from this surgery cannot endure the thought of being awake for such a long surgery.

Dr. Burchiel tested the new technique in a FDA approved study on over 60 patients at the Oregon Health and Science University Hospital and followed them for 18 months..  He is reporting the results of that study in the Journal of Neurosurgery.  Since the study, over 140 more surgeries using the new technique have been successfully performed.  Dr. Burchiel says that although the length of the surgery during the studywas slightly longer than the previous technique, with time, these new surgical techniques should be able to be done in about half the time as before.  DBS surgery may eventually offer new ways of treating Alzheimer’s, depression and even obesity.

 

Kim J. Burchiel, Shirley McCartney, Albert Lee, Ahmed M. Raslan. Accuracy of deep brain stimulation electrode placement using intraoperative computed tomography without microelectrode recordingJournal of Neurosurgery, 2013; : 1 DOI: 10.3171/2013.4.JNS122324

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