After losing all hope of recovering from her long associated depression, 36-year-old patient undergoes surgery which helps her get on the road to recovery.
Depression is a common illness worldwide, with an estimated 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years.
Depression results from a complex interaction of social, psychological, and biological factors.
People who have gone through adverse life events (unemployment, bereavement, traumatic events) are more likely to develop depression.
Recently, a patient suffering from severe depression did not respond to multiple combinations of antidepressant drugs and electroconvulsive therapy.
She had lost all hope of getting better, and it was then that she agreed to undergo the experimental therapy.
A brain pacemaker is a pulse generator that is placed when the patient undergoes deep brain surgery.
The 36-year-old patient, Sarah, said that the therapy had returned her to “a life worth living”, allowing her to laugh spontaneously for the first time in five years.
Although the therapy is relatively new, its success is being seen as a breakthrough in this field.
The project’s lead researcher, Katherine Scangos of UCSF, said that before this, in psychiatry, personalized therapy had never been performed.
She added that the success of this study marks an amazing advance in the understanding of brain function and contributes immensely to the wide arena of studying mental illness.
This article attempts to throw some light on the basis or origin of this advanced surgery, which is being performed in different parts of the world and is more commonly known as Deep Brain Stimulation Surgery or DBS.
Deep Brain Stimulation Surgery (DBS)
It is a neurosurgical approach for those patients who have probably reached the end of the road with medical treatment.
As this procedure is major brain surgery, it requires acute skill and experience. The procedure involves the insertion of an electrode, also known as a lead, into the brain.
The electrode is connected to a thin insulated wire that runs under the skin to a pulse generator device.
The pulse generator is usually implanted under the collar bone in the chest region. When the pulse generator is turned on, it emits electrical impulses transmitted to the brain, which alters neural functioning.
Local anaesthesia is administered to the patient while placing the electrodes in the favoured part of the brain.
It helps the surgeon make sure that the electrode is placed accurately. The surgeon also monitors if there is improvement in the patient’s condition with no side effects.
However, while installing the pacemaker under the collar bone, the patient may be given general anaesthesia.
The side effects may include stroke symptoms, seizures, changes in mood, memory and thinking.
Movement and speech problems may also worsen. Pacemakers may be rechargeable or non-rechargeable.
The kind of pacemaker to be used is decided by the doctor based on the patient’s condition and after several tests.
Treatment of diseases by this procedure
Deep Brain Stimulation Surgery has helped patients suffering from Parkinson’s disease, epilepsy, Obsessive Compulsive Disorder, Depression, Dystonia and essential tremor.
Parkinson’s disease is a neural disorder caused due to the lack of the neurotransmitter dopamine.
For Parkinson’s disease, performing DBS does not necessarily halt the disease’s progression; rather, it simply provides symptomatic relief.
The preferred site for installing the electrodes in such cases is the subthalamic nucleus of the brain.
In patients undergoing DBS, the pacemaker may inhibit action potentials or prompt the release of inhibitory transmitters like GABA.
In most successful cases, after the surgery, the medicines prescribed by the doctor are significantly reduced.
Postoperative care, including visits to the doctor as per the instruction, is of prime importance for the recovery of the patients.
DBS in India
Deep Brain Stimulation Surgery is performed in various parts of India. Dr Paresh Doshi, Asia’s renowned DBS surgeon, has been performing this surgery for several years
Emphasized experience and skill to be of utmost importance while carrying out the difficult surgery.