Brain surgery to cure obsession!
Recently, an Australian who had been suffering from OCD (Obsessive Compulsive Disorder) underwent a psychiatric surgey at Jaslok Hospital, performed by Dr. Paresh Doshi.
Dr. Yusuf Matcheswalla, an eminent psychiatrist in Mumbai, says OCD is an anxiety disorder characterised by obsessive thoughts and compulsive actions such as cleaning, checking on things repeatedly or counting is a potentially disabling condition. ‘The patient is trapped in a pattern of repetitive thoughts and behaviours that are senseless and distressing but extremely difficult to overcome’.
OCD has been linked to abnormalities with the neuro-tranmitter serotonin in the brain which is believed to have a role in regulating anxiety, says Dr. Matcheswalla. He further says ‘to send chemical messages from one neuron to another, serotonin must bind to the receptor sites located on the neighboring nerve cell. It is hypothesised that the serotonin receptors of OCD sufferers may ne relatively under-stimulated’.
Between 2 to 5 % of the world’s population suffers from it and only a handful of these cases worsen into treatment resistant ones.
OCD can have disastrous results in one’s personal and professional life. The Australian’s wife left him and he has been off job since 10 years.
Before surgey he tried medications but nothing worked. In the last 33 years he has undergone 40 sessions of ECT (Electro Convulsive Therapy), and 20 sessions of cognitive and behavioral therpay and transcranial magnetic stimulation but all gave only temporary relief.
Around September 2013, he was suggested at Sydney’s Prince of Wales Hospital to consider neurosurgery to treat his OCD.
The 5-hour surgery on the Australian performed by Dr. Paresh Doshi is called bilateral anterior capsulotomy and involves inserting electrodes in the limbic circuit area of the brain, associated with mood and behaviour.
The surgeons then used a radio-frequency lesion generator to heat the tip of the electrode and create lesions within the brain. ‘We wanted to to work at the ventral part of the anterior limb of the internal capsule, a region deeply embedded in the brain, known to be the nodal point where the behavior and mood pathways converge’, says Dr. Doshi, and adds that six lesions were made on the left and right side of the brain. Because of the damage this caused to the cells, the abnormal activity in the area is likely to reduce.
The Australian was the second patient in India to have undergone this procedure. While India has drafted guidelines in psychiatric surgery (depending on pateint’s treatment history and thorough scrutiny), countries like Sweden and Japan have banned it fearing indiscrimate use.
While it is still too early to conclude how successful the surgery has been, the Australian said, he is feeling ‘lighter’.
Dr. Ajay Sati.
