Deep Brain Stimulation
Definition
Deep brain stimulation (DBS) is a medical treatment involving the implantation of a neurostimulator device, which sends electrical impulses to specific areas of the brain to help regulate abnormal signals. It is commonly used to treat movement disorders such as Parkinson's disease, essential tremor, and dystonia, as well as other neurological conditions like epilepsy and obsessive-compulsive disorder.
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Deep Brain Stimulation
Our expert neurosurgeons specialize in utilizing Deep Brain Stimulation, or DBS, to restore function and quality of life in patients with all types of movement disorders, including Parkinson’s disease. We are the only DBS program in the tri-state area capable of performing all types of DBS implantation surgery, including asleep, frame-based, and frameless DBS. Our state-of-the-art operating room suite offers the accuracy of a powerful 3T MRI. Faulty pathway signals in the parts of the brain that control movement are at the root of many movement disorders. Previous surgical methods (such as ablation) destroyed brain tissue to eliminate the problematic signals. Instead, in DBS, the first procedure involves placing an electrode in the brain. Then, in a second procedure, surgeons connect the electrode to a tiny electrical generator implanted in the chest or abdomen. The generator delivers an electrical current to the area of the brain responsible for the symptoms and blocks them. While DBS is not a cure for movement disorders, it can substantially easesymptoms and decrease the number of necessary medications, limiting side effects and improving quality of life. DBS can also be effective for other conditions, including: Tremor:DBS has proven very effective in controlling and eliminating certain types of tremor. DBS is FDA-approved for the treatment of essential tremor and also helpful for a range of other tremor types. Dystonia:Select patients with severe dystonia have found significant benefit with DBS therapy. Patients with DYT1-positive dystonia have had good responses with this FDA-approved treatment. The effectiveness of DBS varies on the primary or secondary nature of the disease. We thoroughly review each patient to determine the potential benefit. Neuropsychiatric disease:Neurosurgery has long used techniques that destroy brain tissue to treat neuropsychiatric conditions. Today, we are exploring and expanding the use of nondestructive neuron-augmentation for psychiatric disorders, including depression and obsessive-compulsive disorder (OCD). DBS has been helpful for select patients with severe OCD. The use of DBS to treat other neuropsychiatric disorders, such as major depressive disorder and Tourette’s syndrome, is currently being studied, with promising results.Neurology
Yale’s Department of Neurology has been at the forefront of cutting-edge clinical care and scientific discovery since it began in 1952. It was Yale scientists who discovered the genes that cause Multiple Sclerosis. Yale housed one of the first epilepsy monitoring units in the country, and one of the first stroke centers at its partner, the Veterans Affairs (VA) Center in West Haven. Today, our team of experienced doctors are committed to understanding and treating the entire spectrum of nervous system diseases. Expert physicians specialize in brain and nerve health for both children and adults. Specialized care is offered in the following areas: Amyotrophic lateral sclerosis (ALS), myasthenia gravis, peripheral neuropathy, neuromuscular disorders Alzheimer’s disease/cognitive disorders Epilepsy and neurophysiology General neurology, headache, pain Multiple sclerosis and neuroimmunology Neurodegenerative disorders Neurocritical care Neurological infections Neuro-oncology Parkinson’s disease and movement disorders Stroke and vascular neurologyBrain Tumor Surgery
We cover all of the components critical to successfully managing patients with brain tumors. This includes comprehensive evaluation and diagnosis, genomic profiling of the tumor, leading-edge treatment options, follow-up, and psychosocial support. We welcome newly diagnosed patients as well as those who have already received extensive treatment elsewhere, along with patients in need of second surgeries or follow-up biopsies. We work closely with other Yale Medicine brain tumor doctors to provide a comprehensive, multidisciplinary approach that is patient-focused. Using advanced microsurgical techniques, including intraoperative neurophysiological monitoring and awake craniotomy (when appropriate), our brain tumor surgeons strive to achieve the maximum extent of tumor removal while preserving neurological function. Often, what is often deemed "inoperable" by some surgeons is considered operable at Yale with successful outcomes. We are the only hospital in the region to have MRI and angiography capabilities in our operating room. Yale New Haven Hospital also banks all tumor samples and performs genomic profiling to better understand tumor mutations. We use this information to help direct postsurgical therapy. Our state-of-the-art neurosurgical operating rooms in Smilow Cancer Hospital are the only in the regionto offer intraoperative MRI, intraoperative angiography, stereotactic surgical guidance, and operative brain mapping to precisely pinpoint brain tumors during surgery.These technologies, combined with our surgical expertise allow for the best in surgical care for patients. A team of experts dedicated to caring for patients with brain tumors, including specialized brain tumor surgeons, radiation oncologists, neuroradiologists, medical neuro-oncologists, neuropathologists, and other specialists meets weekly to arrive at the most advanced and appropriate treatment plan for each individual. Yale is one of the few centers capable of offering even more personalized and precise oncologic care, when appropriate, based on the genetic makeup of the individual’s tumor. Inquiries from referring physicians or directly from patients or their families are welcome. All inquiries are handled expeditiously by our team of experienced patient coordinators. Their role includes ensuring that appropriate appointments are made in a timely fashion, and coordinating with the various medical specialists involved in each treatment plan. New patients with brain tumors are usually seen within two or three days. Our patient coordinators also act as patient advocates, communicating with the various medical specialists contributing to the treatment plan. Through Yale’s strong tradition of and commitment to research, practitioners are well acquainted with the most advanced treatment methods and have access to clinical trials. Patients also benefit from the specialized resources at Smilow Cancer Hospital and Yale New Haven Hospital, such as an advance