First Deep Brain Stimulation (DBS) Surgery for Parkinson's Disease

Parkinson’s Disease is caused by the loss of dopamine producing neurons in the substantia nigra, a midbrain region that helps regulate movement. This disrupts basal ganglia motor circuits (controls voluntary movements) and leads to symptoms like tremors, rigidity, bradykinesia, and postural instability, which get worse along with the progression of the disease. 

While medication like levodopa would control symptoms, long term use often resulted in drug induced dyskinesias (abnormal and uncontrollable movements in face, tongue, or body), which could lead to surgery. Before DBS surgery, Parkinson’s symptoms would be treated with lesioning procedures (procedures that would intentionally damage or remove areas of the brain) which would cause permanent damage to the tissue, making it impractical.

The first modern deep brain stimulation (DBS) surgery for tremor was performed in 1987 by neurosurgeon Alim-Louis Benabid in France with the use of a neurostimulator. This surgery consists of high frequency stimulation of the ventral intermediate nucleus, a region in the thalamus involved in sensory and motor functions. This can suppress the tremor effectively without destroying brain tissue. Think of it like a pacemaker for the brain, there will be frequent/permanent electrical stimulation to the area which regulates nervous activity. DBS was later expanded to treat other regions of the brain like the subthalamic nucleus and globus pallidus internus which are the main surgical stimulation sites for Parkinson’s treatment. 

DBS is revolutionary because it was reversible, adjustable, and safer than prior destructive surgeries. Surgeons can fine tune stimulation strength after the surgery, offering personalized therapy. This marks a shift in neurosurgery introducing the concept of neuromodulation which now could be used to treat other conditions as well. For example, it not only transformed Parkinson’s disease care, but it also expanded into treatments for dystonia, epilepsy, OCD, Tourette’s, and depression. 

Overall, DBS set the foundation for the entire field of therapeutic neurostimulation, as it’s both a clinical breakthrough and a scientific milestone. It showed that instead of destroying parts of the brain, doctors could fine tune its activity, giving people a chance at a better quality of life. This innovation has spread into treatments for many brain disorders and it continues to inspire advances in medicine today.

Written by Nathan Clemente at Incisionary

APA References

Deep brain stimulation (DBS) for the treatment of Parkinson’s disease and other movement disorders | National Institute of Neurological Disorders and Stroke. (n.d.). Www.ninds.nih.gov. https://www.ninds.nih.gov/about-ninds/what-we-do/impact/ninds-contributions-approved-therapies/deep-brain-stimulation-dbs-treatment-parkinsons-disease-and-other-movement-disorders

Hickey, P., & Stacy, M. (2016). Deep Brain Stimulation: A Paradigm Shifting Approach to Treat Parkinson’s Disease. Frontiers in Neuroscience, 10. https://doi.org/10.3389/fnins.2016.00173

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