AANS Neurosurgeon | Volume 29, Number 2, 2020

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Why Doesn’t Deep Brain Stimulation Work for Everyone?

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People with severe Parkinson’s disease or other neurological conditions that cause intractable symptoms such as uncontrollable shaking, muscle spasms, seizures, obsessive thoughts and compulsive behaviors are sometimes treated with electric stimulators placed inside the brain. Such stimulators are designed to interrupt aberrant signaling that causes the debilitating symptoms. The therapy, deep brain stimulation, can provide relief to some people. But in others, it can cause side effects such as memory lapses, mood changes or loss of coordination, without much improvement of symptoms.

Now, a study from researchers at Washington University School of Medicine in St. Louis may help explain why the effects of deep-brain stimulation can vary so much – and points the way toward improving the treatment. The stimulators typically are implanted in structures known as the thalamus and the basal ganglia that are near the center of the brain. These structures, the researchers found, serve as hubs where the neurological networks that control movement, vision and other brain functions cross paths and exchange information. Each person’s functional networks are positioned a bit differently, though, so electrodes placed in the same anatomical spot may influence different networks in different people – alleviating symptoms in one but not in another, the researchers said.

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