Amrita Hospital Conducts Kerala’s First Deep Brain Stimulation Procedure

KOCHI:
Parkinson’s disease is a neurodegenerative illness, which presents with tremulousness of limbs, stiffness, slowness of movements, difficulty in walking, and other systemic symptoms.

The symptoms of Parkinson’s Disease gradually progress with ageing, regardless of treatment. In the initial stages of illness, medications can enable the patient to lead a near- normal life. As the disease progresses, the medication effect wears off and patients may even experience abnormal involuntary movements. At this stage, Deep Brain stimulation (DBS) is an excellent procedure to help in managing the illness. It is a minimally invasive surgical procedure performed to treat patients with movement disorders, which includes Parkinson’s disease, dystonia, and tremor, and can also be used to manage patients with drug-refractory epilepsy.

Dr Ashok Pillai, stereotactic and functional neurosurgeon at Amrita Institute of Medical Science, Kochi said, “Parkinson’s disease is a progressive illness, and early intervention is crucial to improve the patient’s quality of life. DBS is a well-established treatment option for
advanced Parkinson’s disease that can significantly improve motor symptoms and reduce medication burden, prolonging the functionality of the patient by almost a decade. With newer advancements in DBS technology, we can further improve the outcome of the procedure, and we encourage patients to seek timely treatment and explore the options available to them.”

Adding further, Dr Saraf Udit Umesh – Neurologist and Movement disorders specialist, Amrita Institute of Medical Science, Kochi said, “DBS is a challenging procedure, mainly due to the precision required. The therapy has evolved substantially over the past several decades. Newer techniques to further improve the outcome with advanced technology are being developed. One such technique is the directional lead system, which helps focus the stimulation in a particular direction. Brain sensing technology is another newer advancement which can detect local field potentials thereby providing patient-specific data to help in programming. With a regular DBS program running since 2017, the team at Amrita Hospital has integrated refinements in brain imaging with high-precision robotic-assisted surgery that allows for excellent results with reduced surgery time under general anesthesia compared to the traditional awake DBS surgery”.

A recent success story is that of a 60-year-old gentleman, with Parkinson’s disease for more than 10 years with significant motor fluctuations. He underwent DBS implantation with the new sensing-enabled directional lead system at the hospital, combined with a neurostimulator with advanced brain sensing capability, which is the first instance of this system being used in Kerala. The patient has shown significant improvement in his quality of life.

Although not curative, DBS significantly improves the quality, helps in reducing the medication burden and prolongs the functionality of the patient by almost a decade. It involves the implantation of a neuro-stimulator (‘brain pacemaker’) in the patient’s body which, through wires connected to the head, sends electrical impulses to specific areas in the brain.

Advances in DBS technology have opened gates to a variety of programming approaches that can be employed to help improve efficacy as well as minimize stimulation-induced side effects. It can also maximize battery life. Moving forward from here, brain sensing may help clinicians understand the physiological aspects of DBS and potentially act as a promising programming strategy to improve patient outcomes.