About Neuromodulation

Neuromodulation is a rapidly-growing field for the treatment of neurological and psychiatric disorders.

It encompasses a wide spectrum of implantable as well as non-implantable advanced medical device technologies that use energy (typically electrical) to enhance or suppress nerve cell and brain activity. Neuromodulation may not completely restore brain function; however, it does help relieve symptoms by altering neurological function back to a more normal state. Examples of electrical neuromodulation devices include: Deep brain stimulation (DBS), Responsive neurostimulation (RNS), Vagal nerve stimulation (VNS) and Temporal interference stimulation (TI). Examples of non-electrical neuromodulation devices include: Transcranial magnetic stimulation (TMS) and Low-intensity focused ultrasound (LIFU).

One of the most prominent neuromodulation therapies is deep brain stimulation (DBS). DBS is a complex surgical technique that involves implanting tiny electrodes into selected regions of the brain. Implantation is guided by magnetic resonance imaging (MRI) or computed tomography (CT) which identifies and locates the exact target within the brain where symptoms are generated. For movement disorders, brain areas targeted for implantation include the thalamus, subthalamic nucleus or globus pallidus. For other conditions where DBS is used such as epilepsy or depression, electrodes are implanted into brain regions involved in those specific disorders.

To enable DBS, brain electrodes (or “leads”) are connected via a thin set of wires to a small surgically implanted, programmable battery, similar to a cardiac pacemaker, that is implanted under the skin beneath the collarbone. The leads carry therapy signals to the electrodes which then deliver tiny electrical signals that calm abnormal brain areas. Stimulation of the programmable battery is easily adjustable and does not require additional surgery if the patient’s condition changes. Each electrode has multiple contacts allowing fine tuning of the exact location of stimulation and stimulation parameters can be adjusted to optimize symptom control and minimize side effects.

The goal of DBS is to treat disabling symptoms by disrupting the abnormal patterns of brain activity. This process restores normal brain rhythms and allows for the restoration of more normal movements - improving the patient’s quality of life. It is commonly used to treat the debilitating symptoms of Parkinson’s disease (i.e. tremor, rigidity, stiffness and slowed movement) and essential tremor, a common neurological movement disorder. In epilepsy, DBS reduces the number of seizures, while in depression it can significantly improve mood.