
The Science Behind Deep Brain Stimulation - acdanger
http://www.smithsonianmag.com/innovation/inside-science-amazing-new-surgery-called-deep-brain-stimulation-180951170/
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caycep
Here are some quibbles - it's not a "new" surgery. Benabid's first cases were
published in 1987 and people have been steadily doing them since. FDA approval
was in '01 or so. I think the amount of patients who have received the device
is now north of 100k. Medtronic's patent on subthalamic stimulation has now
expired, and St. Jude and Boston Scientific are readying competitive devices
(and better in many ways, IMHO) for their own device approval trials. (Boston
Scientific's device traces its lineage to Al Mann and the cochlear implant,
which is a fascinating story in its own right).

It's not even a fancy device in its own right. For the EE folks out there it's
just a wire hooked up into a device based off of Medtronic's cardiac
pacemakers. It's a square wave that's generated by a capacitor discharge, with
some simple bread board inside to allow programming of pulse duration, voltage
amplitude, and frequency.

That being said, the effects are indeed fascinating, and no one is sure
exactly why it works. The best review papers that I can be gotten if you
pubmed Cameron McIntyre, Svetlana Miocinovic, Jerry Vitek, or Phil Starr.
There's also an interesting one looking at FFT-generated power spectra taken
from measurements during surgery by Cora de Hemptinne which is pretty good.

Mike Okun and Kelly Foote are pretty cool people, though, good to see them
getting a shout out.

~~~
negarc
I posted a "reply" but it wasn't threaded here -- hope you do see my question
for you in the main comments. Thanks.

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gojomo
There's some hopeful results from noninvasive variants as well, such as
(mentioned once in the article):

[https://en.wikipedia.org/wiki/Transcranial_magnetic_stimulat...](https://en.wikipedia.org/wiki/Transcranial_magnetic_stimulation)

~~~
kanzure
> There's some hopeful results from noninvasive variants as well

including "transcranial ultrasound stimulation",
[http://diyhpl.us/~bryan/papers2/neuro/ultrasound/](http://diyhpl.us/~bryan/papers2/neuro/ultrasound/)

~~~
tachyonbeam
Now I just need to build myself an ultrasound device that temporarily disables
my amygdala, and I can be Paul Muad'Dib.

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negarc
@caycep, thank you for such a clear explanation. If you are so inclined as to
tweak descriptions of "Neuromodulation_medicine" (an overview by me) or other
relevant entries on Wikipedia, I think they need that historical and technical
background . . . I tried to create a scaffold there that could be elaborated
upon by more knowledgeable folk and would be so happy to spark some
contributions of insight to the overview there to make a more robust entry. (I
personally found the barrier to entry to trying to edit there was low despite
whatever drawbacks we've all heard about.)

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lutusp
I have no idea why the linked article doesn't mention DBS as a treatment for
severe depression:

[http://www.healthline.com/health/depression/deep-brain-
stimu...](http://www.healthline.com/health/depression/deep-brain-stimulation-
dbs)

Surely an oversight -- there are at least as many people with severe
depression as with hand tremors and Parkinsonism.

~~~
caycep
Probably because it's still experimental - trials are still ongoing at Toronto
and Emory, and are still considered in the pilot phase. I don't think more
than 40 people have had it done so far, and it's definitely been more
inconsistent in terms of effectiveness compared with Parkinsonism. That being
said, you're right about the epidemiology - there's a lot of depression (and
um....the potential market, which is how Medtronic, the company funding a lot
of the studies, is looking at it). The appropriate clinical selection criteria
for depression surgery, should it ever get approved by the FDA, will have to
be carefully put together...

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throwaway7808
Hmm.

I'm considering a start-up that would make special EMF field interacting
hammers that could be used to reset large scale neuro-networks. Could thing,
is that I think these hammers could actually be used on both, biological and
silicon computational devices! And considering that it probably would be hard
to get an FDA approval [needs about a .1 billion dollars lobbying moneys], at
first we can sell as a panacea-fix-it-all solution for Mac Pro, TV Sets and
Bimmer owners.

Anyone wants to join?

[in 5 years in a " _Science_ of EMF Hammers article": “Can anyone tell me why
this procedure does what it does?” ...

“Well,” says Yllek Etoof, “we know a lot, but not everything.” .... "More than
100,000 people around the world have undergone EMF Hammers since it was first
approved, in the 2016s, for the treatment of movement disorders. Today,
besides providing relief for people with Parkinson’s disease, dystonia
(characterized by involuntary muscl ..... isorder and other neuropsychiatric
conditions, as well as early signs that it may improve memory in Alzheimer’s
patients.

 _Suddenly_ it’s one of the most exciting treatments in modern medicine. With
seemingly millions of potential EMF Hammers patients, it’s easy to imagine a
future where EMF minihammers may become as common as hip replacements. ....
But Nuko says more than 90 percent of their patients rate themselves as “much
improved” or “very much improved” on standard postoperative outcome scales.

In the 12 years since they joined forces, Nuko and Etoof have seen EMF Hammers
evolve, in Nuko’s words, “from crazy, to kind of cool but not completely
accepted, to accepted.” Nuko, 42, recalls: “When I first got hired here, my
chief said to me, ‘You’re a nice kid, you’re a polite kid, but don’t embarrass
us.’”]

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bjourne
You should see this video to really understand how impressive dbs technology
is. Incredible doesn't even begin to describe it.
[https://www.youtube.com/watch?v=uBh2LxTW0s0](https://www.youtube.com/watch?v=uBh2LxTW0s0)

