A neuro-surgical procedure called Deep Brain Stimulation (DBS) offers patients with advanced Parkinson’s disease a new ray of hope, enabling them to lead a near-normal life, neurology specialists at Amrita Institute of Medical Sciences said on the eve of World Parkinson’s Day on April 11, 2018. They also announced the formation of a Parkinson’s Disease Patient Support Group, which was formally inaugurated by Dr. Jayshree Ben Mehta, President, Medical Council of India.

Dr. Anand Kumar, Head, Department of Neurology, Amrita Institute of Medical Sciences, explained, “The Parkinson’s Disease Patient Support Group is initially made up of about 500 patients of Parkinson’s from the Amrita Hospital, but any patient from anywhere in India is welcome to join. Patients will be provided support and counselling through WhatsApp groups.” 

Day-long activities were conducted at Amrita Institute of Medical Sciences to create better awareness about Parkinson’s disease and the latest treatment options available. Apart from Dr. Jayshree Ben Mehta of MCI, other prominent people in attendance included Swami Purnamritananda Puri, General Secretary, Mata Amritanandamayi Math; Dr. Prem Nair, Medical Director, Amrita Hospital; Dr. Col. Vishal Marwaha, Principal, Amrita School of Medicine and Dr. Rani Nair, Professor, Dept. of Neurology, Amrita Institute of Medical Sciences. 

Addressing the media about the breakthrough DBS procedure, Dr. Ashok Pillai, Clinical Professor, Dept. of Neurosurgery, Amrita Hospital, commented: “Deep Brain Stimulation surgery is now being offered in Kerala. It involves the implantation of a neuro-stimulator, often called ‘brain pacemaker,’ in the patient’s body. It is connected to the head through wires which send electrical impulses to specific areas deep in the brain. DBS is a boon to patients with advanced Parkinson’s Disease with drug-induced problems or where drugs are failing. It offers patients much better control over the symptoms and an enhanced quality of life. In addition, the robotic technology called ROSA can ensure very high precision during the implantation of the neuro-stimulator. It enables minimally invasive surgery of the central nervous system with a level of precision not possible by human hand.” 

“DBS is meant for Parkinson’s patients up to 70 years of age who do not respond well to treatment and are unable to manage their day-to-day activities because of their motor problems. They either have frequent ‘off’ periods when they are hardly able to make motor movements, or they have excess of unwanted movements which can be very troublesome and are present up to 75% of the time that they are awake. Patients who have had at least five years of symptoms of Parkinson’s Disease are eligible for this procedure, which takes just four to five hours. Nowadays, robotic frameless surgeries are coming into vogue which are much more comfortable for patients.” 

Dr. R Suresh Kumar, Professor, Dept. of Neurology, Amrita Hospital added, “DBS is not a cure but it significantly improves quality of life of the patient. However, there are less than 20 centers in India which offer DBS implantation. In Kerala, only two or three hospitals offer a regular DBS program. This is not enough as about 33 to 41 patients per one lakh population suffer from Parkinson’s disease in the country. DBS is a costly treatment and also there is a lack of awareness among patients about this procedure, which is an obstacle to its widespread adoption.” 

DBS surgery involves two stages. The first is the “awake stage” in which the patient remains awake when the surgeon inserts the electrodes in the head, and a neurologist assists the surgeon in deciding the exact target based on a clinical examination of the patient. The second stage is done under general anesthesia and involves fixing the neuro-stimulator in a pocket made in the chest muscles and tunneling the wires through the neck tissue to the head. 

Last year, Amrita Institute of Medical Sciences conducted Asia’s first Robotic Assisted DBS Implantation for Parkinson’s disease on a 45-year-old auto-rickshaw driver Zubair, hailing from Guruvayoor district, fully curing him of symptoms and allowing him to return to his job.