A team from VIMHANS in the capital has successfully implanted a pacemaker in the brain of an OCD patient, which has "significantly reduced her peculiarities in just two weeks time".
The team, including neurosurgeons Dr Alok Gupta and Dr Sanjeev Kumar and psychiatrist Dr Ashutosh Tripathi, used Deep Brain Stimulation (DBS) to implant the pacemaker for sending electrical impulses to specific parts of the brain.
DBS, which has been used in select brain regions till now, has provided remarkable therapeutic benefits for disorders like such as Parkinson's and dystonia. However, it has been used for the first time to treat OCD.
" DBS involves precise stimulation of particular parts of the brain through the implantation of removable electrodes. Two electrodes have been wired to both sides of patient's brain (anterior limb of internal capsule) which communicate through the pacemaker, the battery of which has been put inside her chest. We can alter the function of any part of the brain by stimulating it. If stimulated with low frequency electrodes, the area starts to get excited. With high frequency, it blocks off the pathway and reduces symptoms. In her case, we used high frequency electrodes to block the pathway of the brain that was causing OCD," Dr Gupta explained.
The 48-year female patient had been suffering from OCD for the past 21 years.She had been living in constant fear of all kinds of touch, scared that any contact with her children or object would severely soil her hands.
Her condition had become so acute that she stopped eating or going to the toilet on her own. In fact, she would sit all day on the bed without touching anything, waiting for her children or husband to feed her or take her to the toilet.
To make matters worse, if she touched anything by mistake, she would wash it several times. Strangely, she would not turn off the tap even after using it.
"Two weeks since the implant, she has not just started eating on her own but is now completely independent," Dr Gupta added.
Though there are a number of medications and psychological therapies available to treat OCD, it is estimated that about 10% patients don't respond adequately to these first-line interventions.
"DBS is for those patients who don't respond to medication. Psychiatrists need to identify these patients before the brain pacemaker could be used. Besides, the price of this form of treatment is yet to be determined. DBS used for Parkinson's patients costs $8000 in India," Dr Gupta said.
DBS has several advantages over traditional brain surgery for OCD. It can be used to treat symptoms with little risk of permanent changes in the brain. The level of stimulation can be adjusted, and the stimulation can be used continuously or intermittently depending on the treatment plan.
Since the surgery is minimally invasive, it has a reduced potential for side effects.
http://timesofindia.indiatimes.com/india/In-a-first-pacemaker-fitted-in-brain-helps-cure-OCD/articleshow/6555082.cms
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