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Pacemakers for the Brain

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Pacemakers for the Brain
Payton Jackson
University of Louisiana at Monroe When hearing the word pacemaker, the first thought that comes to one’s mind is a cardiac pacemaker. With a pacemaker for the brain, the wires are implanted in the brain instead of heart. Some of the things that brain pacemakers have been seen to do with medical and technological advances are reducing seizures in people with epilepsy, controlling the tremors of people with Parkinson’s disease, the testing for treatments of bipolar disorder and depression. The modern medical and technological advances that have been made contributes to all of those things.
A brain pacemaker, also known as a neurostimulator, is implanted through a surgical procedure called deep brain stimulation. This is an invasive, chronically implanted device that uses electrical stimulation to alleviate dysfunctions of the brain (Johansson, Garwicz, Kanje, Halldenius, Schouenborg, 2015). There are three components to this pacemaker which are a lead, an extension, and an implantable pulse generator. According to the National Institute of Neurological Disorders and Stroke (2015), “the lead (also called an electrode)—a thin, insulated wire—is inserted through a small opening in the skull and implanted in the brain. The tip of the electrode is positioned within the specific brain area. The extension is an insulated wire that is passed under the skin of the head, neck, and shoulder, connecting the lead to the implantable pulse generator. The implantable pulse generator (the "battery pack") is the third component and is usually implanted under the skin near the collarbone. In some cases, it may be implanted lower in the chest or under the skin over the abdomen. Once the system is in place, electrical impulses are sent from the implantable pulse generator up along the extension wire and the lead and into the brain”. Theses pacemakers consume more energy than cardiac pacemakers.
Through ongoing research, it has been shown that pacemakers for the brain work as a form of therapy for Parkinson’s disease, dystonia, epilepsy, anorexia, depression, and Alzheimer’s disease. With Parkinson’s disease, it can control the symptoms so that medication is not needed anymore. For those with Alzheimer’s, it could enhance memory and thinking skills. The first successful implant with a brain pacemakers was in France in 1987. In 1997, the first use of pacemakers to treat Parkinson’s disease was approved by the U.S Food and Drug Administration. In 2012, during a five-hour surgery, a brain pacemaker implanted to treat Alzheimer’s at Ohio State University Wexner Medical Center. Another pacemaker was implanted for the treatment of Alzheimer’s in 2012 at John Hopkins Medical Center. “Compared with ablative procedures, deep brain stimulation has the advantage of being reversible and adjustable. It is considered safer than ablative surgery, in particular for bilateral procedures, which are often needed for patients with advanced Parkinson disease and other movement disorders” (Machado, Fernandez, Deogaonkar, 2012). There are potential complications for this device just like any other procedure. The implant itself could be rejected. An infection may occur at the site of the incision. Another risk is that the implants could cause a blood clot. There have been some ethical concerns when it comes to these pacemakers. “Deep brain stimulation (DBS) is a recent example of how technological development may give rise to ethical concerns. The number of articles discussing the ethical implications of possibilities and problems raised by DBS is increasing. Thus far, DBS has been a recurring topic in leading bioethical journals such as AJOB Neuroscience and Neuroethics, and there have been many important contributions focusing on specific bioethical issues such as medical risks, consent, patient selection, and justifiable new indications or general features such as ethical challenges raised by DBS during research and clinical practice, respectively” (Johansson, Garwicz, Kanje, Halldenius, Schouenborg, 2015). Pacemakers for the brain are still being studied and there are developments being made to improve it. These improvements will be helpful to those who would benefit from these pacemakers.
References
Johansson, V., Garwicz, M., Kanje, M., Halldenius, L., & Schouenborg, J. (2014). Thinking ahead on deep brain stimulation: An analysis of the ethical implications of a developing technology. AJOB Neuroscience, 5(1), 24-33. Retrieved from http://dx.doi.org/10.1080/21507740.2013.863243
Machado, A., Fernandez, H., & Deogaonkar, M. (2012). Deep brain stimulation: What can patients expect from it?. Cleveland Clinic journal of medicine, 79(2), 113. Retrieved from http://dx.doi.org/10.3949/ccjm78gr.11006
National Institute of Neurological Disorders and Stroke. (2015 July 27). Deep Brain Stimulation for Parkinson's Disease Information Page. Retrieved April 11, 2016, from http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm

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