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Deep brain stimulation

Deep brain stimulation (DBS) is currently being used in the treatment of symptoms in movement disorders like Parkinson’s disease. Clinical trials are underway exploring the use of DBS for treatment-resistant forms of various disorders including post-traumatic stress disorder (PTSD), alcohol use disorder (AUD), obsessive-compulsive disorder (OCD) and major depressive disorder (MDD) at Sunnybrook’s Harquail Centre for Neuromodulation.

DBS is a neurosurgical procedure that directly impacts dysfunctioning brain circuits. It involves inserting thin electrodes into deep brain structures and electrically stimulating them in a controllable and ultimately reversible manner with a pacemaker-like device.

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Sunnybrook researchers are conducting ground-breaking DBS trials. For the first time in North America our researchers have launched a study investigating the use of DBS for treatment-resistant AUD. They are also examining DBS in the treatment of hard-to-treat PTSD in a Canadian-first trial. 

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Frequently asked questions

What is DBS?

DBS involves implanting electrodes to influence abnormal activity in circuits of the brain. For over 25 years, DBS has been used to help treat Parkinson’s disease. Nearly 200,000 DBS surgeries have been performed worldwide, the majority, for movement disorders like Parkinson’s disease. It is also approved for the treatment of obsessive-compulsive disorder (OCD), and is being investigated as a treatment for major depressive disorder (MDD).

For the first time in North America, Sunnybrook researchers are investigating DBS as an experimental treatment for symptoms of treatment-resistant alcohol dependence. Our researchers have also embarked on a Canadian first, as DBS is currently being studied for treatment-resistant PTSD.

What equipment is involved in DBS?

DBS is like a pacemaker for the brain. Two electrodes travel through nickel-sized holes in the skull into precisely targeted brain regions. These electrodes are placed beneath the skin and connect to a battery just below the collarbone. The battery provides a small amount of electricity delivered through the tips of the electrodes in the targeted brain areas to interrupt brain circuits that are functioning abnormally.

What studies are investigating the use of DBS?

There are currently four active studies at Sunnybrook’s Harquail Centre for Neuromodulation investigating the use of DBS for the following disorders that are treatment-resistant, meaning they are not responsive to conventional therapies such as psychotherapy and medication. They include:

  1. DBS for alcohol use disorder (AUD)
  2. DBS for post-traumatic stress disorder (PTSD)
  3. DBS for major depressive disorder (MDD)
  4. DBS for obsessive compulsive disorder (OCD)

Is DBS a first-line treatment?

No. At this point, DBS is a new experimental procedure that is being tested for safety for the treatment of severe psychiatric conditions.

To be included in the DBS trial for treatment-resistant AUD, PTSD, MDD, or OCD, a patient must have tried all other treatments including medication and psychotherapy. DBS is not intended to replace other treatments, but to add or complement other treatments in patients who are not improving with conventional treatments. Both trials will include between five to ten patients each.

Current research suggests that there are similarities between the symptoms of PTSD and those of anxiety and depression. Given that DBS has shown promise in the treatment of these conditions, the Phase I trial was designed to investigate if DBS could be an effective therapy for treatment-resistant PTSD as well.

Is DBS safe?

DBS is used in Canada and around the world to help alleviate symptoms of movement disorders like Parkinson’s disease and essential tremor. It is also being studied for possible treatment of psychiatric disorders such as OCD and depression.

For the first time in North America, Sunnybrook researchers are studying DBS in the treatment of patients diagnosed with alcohol use disorder who have not responded to conventional treatment.

In a Canadian first, DBS is also being investigated at Sunnybrook for patients with treatment-resistant PTSD.

What parts of the brain will be treated and why?

Different parts of the brain play a role in different disorders. In each trial, researchers will target circuits of the brain that may help regulate or control symptoms. The latest in brain imaging technology will help precisely locate the key regions as leading-edge, direct-to-brain therapies are being investigated.

How effective is DBS?

DBS for difficult to treat chronic alcohol dependence and PTSD is currently being tested for safety as an experimental treatment at Sunnybrook. As a result, the effectiveness of DBS for AUD and PTSD is still being investigated. However, DBS is an established treatment for movement disorders such as essential tremor, Parkinson’s disease, and OCD.

What are the potential risks with this procedure?

Any type of surgery has the risk of complications. Risks of DBS are similar to any neurosurgical procedure such as injury to the brain (stroke), bleeding, infection, seizures, cardiac problems, pain (e.g. headaches) and nausea. Other side effects may include unexpected mood changes or issues with concentration.

Who do I contact for more information?

For more information, or to inquire about eligibility, please contact Anusha Baskaran, Manager at anusha.baskaran@sunnybrook.ca or 416-480-6100 ext. 1650.

What are some other resources for PTSD?

What are some other resources for alcohol use disorder?