Tuesday, October 12, 2004

Deep Brain Stimulation and Tourette's Syndrome

Over the past few months, there have been a number of stories in the media about the topic of deep brain stimulation and its possible applications in the near future. The following article comes from Canada’s Globe and Mail:
Surgery helps short-circuit Tourette's syndrome
By PAUL TAYLOR
From Tuesday's Globe and Mail

Jeff Matovic used to eat with a plastic spoon to prevent himself from accidentally gouging out one of his eyes.The 31-year-old has Tourette's syndrome, a neurological disorder characterized by involuntary muscle movements. Mr. Matovic, who developed symptoms at age 3, could not sit, walk or even sleep without his body exploding in an endless series of jerking motions and verbal outbursts. He has broken glasses in his bare hands and dented walls with his head because of sudden muscle contractions.

Things got so bad, Mr. Matovic sought out doctors who would implant electrodes in his brain to quiet his restless body, after hearing about another patient who had the treatment. The operation took place six months ago at the University Hospitals of Cleveland, and his body has been calm ever since.

"It's just amazing. It is truly phenomenal," Mr. Matovic said in a telephone interview from his home in a Cleveland suburb. Before the operation, he could barely talk on a phone because of an irrepressible urge to clear his throat, grunt and hiss -- not to mention the difficulty of holding the receiver.

Mr. Matovic underwent a treatment known as deep-brain stimulation, increasingly used to treat a wide range of brain disorders. Much like a heart pacemaker, the treatment provides a stream of electrical current to counteract a part of the brain that is misbehaving.

During surgery, electrodes are inserted into specific spots in the brain. They are then connected through wires under the skin (beneath the scalp, neck and upper chest) to a replaceable battery unit implanted beneath the collarbone.

Only a handful of people (none in Canada) has received the treatment for Tourette's. But deep-brain stimulation has been used for more than a decade to treat other movement disorders, such as Parkinson's disease, tremors and dystonia, which distorts posture. About 30,000 people around the world now have such brain implants.

As neurosurgeons refine their skills, medical experts speculate that deep-brain stimulation could be used to treat everything from drug addictions to depression. Studies are under way at various medical institutions to expand its use. The technique is proving effective partly because the brain itself operates like an electrical circuit. When even just a few brain cells are misfiring, they can cause widespread problems resulting in either a physical or mental disorder.

A little electrical current, applied in the right place, seems to restore harmony to the discordant symphony of the disordered brain, said Dr. Robert Maciunas, the neurosurgeon who operated on Mr. Matovic.
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