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Deep brain stimulation surgery at Jaslok hospital for treatment resistant depression.
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Dr. Paresh Doshi
Director of Neurosurgery
Director Stereotactic and Functional Neurosurgery Dept.
Jaslok Hospital and Research Centre
Mumbai
DEEP BRAIN STIMULATION (DBS) FOR TREATMENT RESISTANT DEPRESSION (TRD)
DR. PARESH DOSHI
Dr. Paresh Doshi
FIRST CASE IN ASIAN- AUSTRALIAN CONTINENTS
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Dr. Paresh Doshi
• History of Psychiatric disorders surgery
MGH lesional experience
Also include other indication being OCD 25 publications and 130 cases
From where do claim this, world ns paper of mayberg
Papers published in IJP
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Dr. Paresh Doshi
DEEP BRAIN STIMULATON
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Dr. Paresh Doshi
ABOUT FUNCTIONAL NEUROSURGERY DEPT
• Started in 1998
• Offers treatment for Parkinson’s disease, movement disorders, epilepsy, pain, spasticity and psychiatric disorders
• Pioneer in performing several surgeries for the first time in India
• Largest experience of Deep brain stimulation (>250) in India
• Member of board of directors on Asian and the World societies for functional neurosurgery.
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Dr. Paresh Doshi
WHAT IS SUBGENUAL CINGULATE GYRUS (SCCG)
• Located in the frontal lobe
• At the base of the brain
• Close to the midline
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Brain Target
Dr. Paresh Doshi
WHY SCCG
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Inc activity in depression
Dr. Paresh Doshi
MAY 2009- PSYCHOSURGERY CONSENSUS GROUP MEETING
Dr. Paresh Doshi
GUIDELINES
• OCD and Depressionas the only confirmed indication
• Accept published inclusion and exclusion criteria for pt. selection
• Selection to be done with a 100% consensus of one neurosurgeon and two psychiatrists
• Selected case to be further reviewed and confirmed by independent neurologist, neurosurgeon and psychiatrist
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Doshi PK, Indian J Psych, 2009
Dr. Paresh Doshi
WSSFN PSYCHIATRIC FORUM MEETING-SHANGHAI 2011
Dr. Paresh Doshi
LONG TERM RESULTS
• 62% -1yr
• 42% -2yrs
• 75% -3yrs
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Kennedy HS, Lozano et al. Am J Psychiatry 2011; 168:502–510
Dr. Paresh Doshi
BEN’S JOURNEY
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23rd September, 2013
Dr. Paresh Doshi
DAY 1
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Dr. Paresh Doshi
DAY 2
• Picture of consensus group with names tagged
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Dr. Paresh Doshi
DAY 3 : FRAME FIXATION
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Dr. Paresh Doshi
DAY 3: PLANNING
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Dr. Paresh Doshi
DAY 3: SURGICAL SETUP
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Dr. Paresh Doshi
DAY3: INTRAOPERATIVE ASSESSMENT
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Dr. Paresh Doshi
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Dr. Paresh Doshi
DAY 3: FINAL REWARD, BEN SMILING!!!
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Dr. Paresh Doshi
THANK YOU
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