UNDERSTANDING DBS
Deep brain stimulation (DBS) therapy for OCD targets precise areas of the brain linked to obsessive-compulsive disorder.
How It Works
DBS uses a surgically implanted medical device, similar to a cardiac pacemaker, to deliver carefully controlled electrical stimulation. The stimulation is sent to a precisely targeted structure within the brain, the anterior limb of the internal capsule (AIC).
DBS may treat the symptoms of OCD. It is not a cure, and some symptoms may remain even with the treatment. If stimulation is discontinued, the symptoms will likely return.
DBS System
The DBS system is implanted inside the body and includes the following components.
- A lead is a set of thin wires covered with a protective coating. It carries the therapy signal to the electrodes that deliver stimulation to the brain. Approximately 4 inches of the lead are implanted inside the brain. The rest of the lead (about 15 inches) is implanted under the skin of the scalp. Two leads are needed.
- The extension is a set of thin wires covered with a protective coating that connects the lead to the neurostimulator. The extension is connected to the end of the lead, just behind the ear and determined by the doctor. The connection point between the lead and the extension is placed under the scalp. The remaining length of the extension is placed under the skin down the neck to the upper chest area and connects to the neurostimulator. For each lead there is one extension.
- One or two neurostimulators are used for treatment of OCD. They are the power source of the DBS system. They generate and control the therapy stimulation. Each neurostimulator is implanted just under the skin in the upper chest area.
These electrical pulses are delivered through the extension and lead to the targeted areas in the brain. The doctor can adjust the pulses wirelessly to check or change the neurostimulator settings
Finding the Right Level of Stimulation
Once the neurostimulator has been activated following surgery, it can be programmed by the doctor to find the level of stimulation that maximises benefits while minimising side effects. The doctor uses a programming device to make non-invasive adjustments to the neurostimulator. It may take several months to find the right level of stimulation.
Depending on the system and the therapy needs, the patient may have a controller that will allows to turn the system on and off, adjust the stimulation, and check the battery.
How long the neurostimulator's battery lasts depends on the settings. Before the battery runs out, the neurostimulator can be replaced in a surgical procedure that does not require an overnight stay in the hospital. Leads and extensions don’t typically need to be replaced.