Implanted & surgical write · writes
Deep brain stimulation is a surgical therapy that stimulates the brain electrically without destroying tissue: an electrode implanted inside the skull, wired to an implanted pulse generator, delivers electrical impulses to a focal brain region. The electric field acts on cell bodies, dendrites, axons and glia, but the clinical effect is attributed mainly to exciting axons, and high-frequency stimulation may block local low-frequency oscillations. Closed-loop versions also read local field potentials, such as subthalamic beta or cortical gamma activity, and use them to trigger or adjust the stimulation.
Deep brain stimulation (DBS) is a surgical therapy that stimulates the brain electrically without destroying tissue. An electrode implanted inside the skull is connected by an extension wire to an implanted pulse generator, which delivers adjustable electrical impulses to a focal brain region. It is standard care for Parkinson disease, tremor and dystonia. The electric field acts on cell bodies, dendrites, axons and glia, but the clinical effect is attributed mainly to axonal excitation: axons follow pulse trains near 100 Hz faithfully, and synapses transmit such trains less reliably. High-frequency DBS may act as a local information lesion that blocks low-frequency oscillations with little effect on the wider network. Segmented electrodes steer the current direction. The labelled stimulation range of one FDA-approved DBS pulse generator is 2-255 Hz with pulse widths of 10-450 µs. On-demand stimulation is triggered by an event, such as arm movement in essential tremor or seizure activity in epilepsy. Adaptive stimulation is adjusted continuously by a feedback signal: beta power in the subthalamic nucleus local field potential, or gamma activity from a cortical strip electrode as a marker of dyskinesia. Seizure-triggered closed-loop stimulation is promising and needs further exploration.
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