1. Deep Brain Stimulation Mark Anil Mansingh Simon Putzenlechner Philipp Bartner

2. Introduction „Pacemaker“ for brain Reversible neurosurgical procedure approx. 120000 patients treated worldwide Remarkably increases lifequaltiy

3. Indications Tremor Parkinsons Dystonia OCDs Epilepsy

4. Function ??? not completely understood ??? Functional block of axons Synaptic Inhibtion Exhaustion of NTMs via continous excitation changes in pathological activity of brain

5. Device battery-powered chipcontrolled pacemaker Trail in 2010: 8 contacs per hemisphere

6. Side effects Dysarthria (short- / longterm) Manic behavior Depression Sources: http://de.wikipedia.org/wiki/Tiefe_Hirnstimulation http://de.wikipedia.org/wiki/Tiefe_Hirnstimulation http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_ stimulation.htm http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_ stimulation.htm

7. History of DBS Electricity and its effects on human body in early age  experiments with electric rays 1800‘s: electricity became useable for humans  mapping of brain cortex

8. 1938: electric shock therapy as treatment of severe psychosis 1947: Ernst Spiegel and Henry Wycis localize BG via electrical stimulation and destruction of certain areas by radiofrequency therapy  stimulation itsself has therapeutic effect DBS became focus for further research

9. Many treatment possibilities were only found by chance not by planning Middle aged heroin addict, 22 years of therapy but all therapies failed  DBS surgery first effect: drastic increase in heroin consumption

10. 2006 Jens Kuhn trying to treat a panic disorder patient  after DBS panic attacks were left unchanged, but his alcohol intake was unintentionally decreased  Drug dependace therapy

11. 2013 treatment of obesity instead of treating obesity, a patient was left with an enhanced memory capacity, making him able to recall detailed memories from 30 years prior Chance of Alzheimer‘s disease treatment? Also ethical problems may arise from DBS

12. DBS is today used to treat: – Parkinson's disease – Chronic pain – Major depression – Tourette syndrome – epilepsy that is resistant to medication Sources: – http://www.scientificamerican.com/article/psychiatrists-embrace- deep-brain-stimulation/?page=2 http://www.scientificamerican.com/article/psychiatrists-embrace- deep-brain-stimulation/?page=2 – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157831/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157831/ – http://en.wikipedia.org/wiki/Deep_brain_stimulation http://en.wikipedia.org/wiki/Deep_brain_stimulation

13. Applications of deep brain stimulation. Parkinsonsins What is parkinsons? When is it used? When drugs don’t alleviate Pathophysiology is not understood, it stimulates nerve cells

14. Different areas of the brain can be targeted for this treatment : Subthalamic nucleus Globus Pallidus Can also target other sites such as zona incerta

15. Drawbacks of DBS Always prefer conservative methods of treatment first. (also with depression and turett’s, and chronic pain) DBS carries with it all the risks of major surgery. Hemorrhage and infection can occur incidence less than 5 percent.