Deep Brain Stimulation for Movement Disorder Diseases

Movement Disorder Disease (MDD) is one general type of diseases that severely impair human motor ability and reduce the body controllability. Over millions of people in North America are suffering from these diseases and Parkinson's disease (PD) is one of the most typical and common among them. PD is the second most prevalent neurodegenerative disease, affecting over 500,000 people in America and about 4-5% of people over 85. Deep brain stimulation (DBS) is the surgical implantation of a brain pacemaker to generate electrical impulses and stimulate specific parts of the brain. DBS is an effective, FDA approved treatment of PD. From the long term surgical outcome, DBS has been proven to be one of the most remarkable therapeutic procedure for a diverse array of movement disorder diseases and some physiological syndromes, including PD, dystonia, essential tremor and chronic pain etc. This report is organized as follows. In the first section, this report would briefly introduce the background information on MDD, its typical syndrome and its engineering implication. The second section would perceive DBS application from an historical background. Tough the underlying mechanism of DBS is still not clear, and we would present some research hypothesis and the working principle of DBS in practice. The physiology analysis and stimulation targets would be explained. On the other hand, even though DBS has demonstrated good surgical outcome from a 5 year clinician observation, it is not the always first option for PD patients and there is strict patient selection criteria. The third section focuses on the surgical procedure and categorizes them into two different approaches: the frame based and frameless stereotactic surgery. The DBS lead placement workflow and some commercially available medical apparatus and the working principles would be introduced. A comparison between the two approaches and some related technical issues would be presented. The last section illustrates the operation cost and articulates the surgical benefits, complications and risks. Some state of the art technology, including robot assisted interventional MRI technique would be presented here also. This report aims to make brief introduction to MDD with an emphasis on PD and present the basic concepts of DBS and illustrate the practical surgical procedures. BME 523 (Fall 2009) Final Project Report, Hao Su