Deep Brain Stimulation in Parkinson's Disease - Essay Sample

Introduction

Parkinson`s disease (PD) is known to be a disabling long-lasting neurodegenerative problem which is clinically associated with signs of akinesia, postural instability, rigidity, and tremor which is caused commonly by dopaminergic neuron deterioration of the cells in the substantia nigra (Itakura, (Ed.). 2014). The treatment of Parkinson`s disorder is eventually hindered by the alarming occurrence of motor difficulties which includes wearing-off, troublesome hyperkinesias, and sudden-off occurrences. The deep brain stimulation (DBS) that has the motor thalamus, (VIM) ventral intermedius nucleus was utilized for the first time in 1986 to cure medically refractory tremor in PD (Itakura, (Ed.). 2014).

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Most of the surgical therapies are considered in the course of PD, specifically when the symptoms are not adequately regulated with the applied medications. Therefore, DBS is commonly executed surgical medication for PD disorder, but it cannot be performed for everyone. DBS is generally performed for the patients who have had Parkinson`s disease for at least four years and continue to receive advantages from the treatment, but they experience motor complexities like a fundamental "off" period and dyskinesia which is unregulated movements (Itakura, (Ed.) 2014). Notably, DBS medication works perfectly to reduce motor symptoms such as tremor, stiffness, and slowness. Thus, DBS treatment has been confirmed to be the most effective therapeutic choice in the movement diseases caused by aggregate proteins such as Parkinson`s disease (PD). The treatment is proven that when applied successfully it will alleviate symptoms associated with Parkinson`s Disease.

The use of DBS surgery has greatly increased in the advanced treatment of Parkinson`s disease. Based on previous research conducted, it was found that DBS is superior for best medical management in properly chosen patients. The key target for DBS treatment in Parkinson`s disorder include the internal section of the globus pallidus and the subthalamic nucleus; they both improve cardinal motor characteristics in Parkinson`s disease.

Summary of Electric Stimulation

There are various types of electric stimulation which are used to treat various health situation related to human. The physical therapist utilizes multiple types of electrical stimulation to complete health disorders with related scenarios to human. These electronic stimulations include transcutaneous electrical neuromuscular stimulation (TENS), Iontophoresis electrical stimulation, neuromuscular electrical stimulation (NMES), Russian stimulation, high voltage galvanic current and interferential current (IFC) (Perestelo-Perez et al. 2014).

TENS is a form of electrical stimulation which is used by the therapist to manage chronic and acute pain in physical therapy. Iontophoresis is a kind of electrical stimulation that is utilized to assist administers treatment to you in physical therapy. The drugs of iontophoresis can be utilized to break up deposits of calcium that occurs in situations like shoulder calcific tendonitis. Also, NMES is an electrical stimulation that uses electrical current to source a single muscle to contact. Another type of electrical stimulation used by a physical therapist is the Russian stimulation which can be used to carry out similar activities with NMES such as to enhance the way muscles contract (Hickey & Stacy, 2016). But Russian stimulation utilizes various waveforms that are more comfortable to tolerate human (Itakura, (Ed.). 2014).

The Design and Application to Human Organ or Tissue

Therefore, to manage aggregation disorder such as Parkinson`s disease, some design and application should be carried out to human organ or tissue to reduce the disease. The application that should be done to the human organ with protein aggregation disease is medications for the Parkinson`s disease, apply deep brain stimulation, and nurses should provide the multidisciplinary therapy (Perestelo-Perez et al. 2014). The design for protein aggregated human organ is to give medication therapies that focus on maximizing the availability of dopamine in the brain. Thus, the appropriate treatment for Parkinson`s disease can be applied in the following categories:

• Levodopa which is the dopamine replacement therapy
• Dopamine agonists which help to mimic the action of dopamine

COMT inhibitors are applied along with levodopa. This medication, when applied in protein aggregated human organ, will assist in blocking a COMT enzyme which prevents levodopa from breaking down in the intestine thus enabling more of it to be absorbed in the brain.

Anticholinergic is a medication in the tissue that blocks the impacts of another brain chemical to re-balance its ranks with dopamine.

Deep brain stimulation (DBS) is a surgical treatment to implant an electrode or devices that transmit electrical signals to the brain region responsible for the body movement. Electrodes are inserted deep in the brain and connected to a stimulator device. DBS treatment assists in mitigating the symptoms of slowness, walking problems, tremor and stiffness triggered by Parkinson`s disease (Johnson, Xu, Baker, Zhang, & Vitek, 2015). DBS treatment which has been done successfully enables the individual to mitigate their treatment and recover their high quality life potentially.

The electrodes are inserted on both rights and left sides of the brain through tiny holes made at the upper region of the skull. The electrodes are joined by long wires that move under the skin and down the neck region to a battery-powered stimulator under the skin in the chest section. When the powering battery is turned on, the stimulator propels electrical pulses to block the defective nerve signals which cause rigidity, tremor and other symptoms of Parkinson`s disease. In the DBS medication, multiple electrodes are used which are inserted into the brain based on the computation from the MRI/CT scans and computer planning.

Electric Voltage, Current, Ac Frequency

According to the study done by the health department, it was found that low-amplitude sine-wave in human organ electrical stimulation (ES) initiates human soft tissue to response in the non-existence of injury in Procambarus clarkii (Hickey & Stacy, 2016). In the health situation of an individual, the alternating currency is utilized to develop an electrical field within the fracture site which needs to be treated. Capacities of 1 to 10V at frequencies of Ac of 20 to 200 kHz are subjected to the electrodes (Itakura, (Ed.). 2014). Hence it will result in the establishment of electrical fields of 1 to 100mV/cm that helps in the healing of wounds in the fracture site. The amplitude and duration of electrical fields which is generated by current, uplift bone cell proliferation which is needed in the treatment of injuries.

Electric voltage is the selected stimulation paradigm that helps in the health situation as an efficient and effective system to support cell differentiation (Hickey & Stacy, 2016). From the experiment conducted, the longer duration and amplitude of electric voltage depicts that cells and tissues remained intact in the culture plate regardless of the morphological variations around the electrode. Thus, the longer the duration the similar electric voltage will increase the evaporation rate medium as a result of non-dynamic medium flow in the organs system. Longer duration and amplitude with higher voltages will make culture medium to fragment into two phases because of water electrolysis.

Cells or Tissues Responds to the Electric Stimulation

Neurons are a part of the brain cells that respond to DBS treatment in the brain. Neurons receive an electrochemical signal sent from the nervous and brain system. These brain cells are the units of communication that are connected by synapses which creates brain network. DBS of the subthalamic nucleus (STN) is a well-designed surgical therapy for the treatment of advanced PD (Johnson et al., 2015). From the research conducted on how the brain cells response to DBS, an emerging hypothesis was presented that the therapeutic advantages of DBS are derived in the direct modulation of the initial motor cortex (M1).

Moreover, the influence of STN deep brain stimulation medication on the individual's brain neurons in M1 is also known. The subthalamic DBS fundamentally modulated the firing of a major of brain neurons; therefore, the direction of impacts differs with stimulus strength. The higher the intensity, the more the brains neutrons are activated to respond to DBS medication thus resulting in successful treatment for patients with Parkinson`s disease (Johnson et al., 2015).

Also, neuromuscular, muscle and nerve tissues response to electrical stimulations; thus they can initiate and disseminate the activity needed for the medication in DBS. Soft tissues in the human organ are a complex procedure that needs certain communication with different cell types that responds to electrical stimulations to orchestrate efficient restoration of the physiological role. Understanding critically the signaling mechanisms which entail macrophage recruitment has been considered to play a crucial function in healing wounds starting at the inception of tissue injury.

The response cells in the brain to DBS is essential to people affected with PD since it will help in the effectiveness of medication through smooth transmission of the pulse. STN-DBS outcomes with the smooth response of brain cells such as neurons reduce the dopaminergic and dyskinesias treatment of PD thus improving all the cardinal and cortex motor symptoms with persistent benefits to people with PD (Johnson et al., 2015). Hence, they will experience high quality of life with the best DBS medications.

The Effectiveness of the Treatment

The researchers have concluded that the effectiveness of DBS treatment can be assessed well in the early stage of motor complications and Parkinson`s diseases. Therefore, to account the efficacy of the DBS treatment, the researchers will assess the quality of life which is measured by a PDQ-39 questionnaire and also from the social working from a short-term psychosocial SCOPA-PS questionnaire (Beuter et al., 2014).

The effectiveness of the treatment is assessed through the changes in the critical area of motor disability and acts of daily living of an individual utilizing the scale known as UPDRS II. The effectiveness of the treatment can also be assessed by checking the improvements in the difficulty resulting from utilizing levodopa which is one of the key drugs for Parkinson`s medications.

Side Effect of the Treatment

The treatment of Parkinson`s disorder was found to assist in relieving the muscle pain and rigidity, and thus the medication prescribed for the medication of Parkinson`s disease have some additional side effects. Among the side effect of the treatment is a hallucination which is caused by too much dopamine chemicals in the brain which is used more frequently in treatment. Thus, too much dopamine in the brain causes psychosis and hallucination as the side effects. Another side effect of the treatment is surgery risks. DBS involves the establishment of holes in the skull what will be used to implant the electrodes and to implant the surgery device that entails the batteries under the skin in the human chest (Beuter et al., 2014). The possible effects of the treatment after surgery include:

• Infection
• Seizure
• Stroke
• Difficulty in concentration
• Confusion
• Temporary swelling and pain in the implantation site
• Hardware complication like lead wire eroding

Contribution of Electric Engineer in Area of Medicine

Electrical engineer plays a crucial role in the treatment of Parkinson`s disease; it assists in the advancement in deep brain stimulation for the treatment o...