Dbs for depression

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Deep brain stimulation surgery at Jaslok hospital for treatment resistant depression.

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Dbs for depression

  1. 1. 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
  2. 2. Dr. Paresh Doshi FIRST CASE IN ASIAN- AUSTRALIAN CONTINENTS
  3. 3. 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
  4. 4. Dr. Paresh Doshi DEEP BRAIN STIMULATON
  5. 5. 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.
  6. 6. Dr. Paresh Doshi WHAT IS SUBGENUAL CINGULATE GYRUS (SCCG) • Located in the frontal lobe • At the base of the brain • Close to the midline Brain Target
  7. 7. Dr. Paresh Doshi WHY SCCG Inc activity in depression
  8. 8. Dr. Paresh Doshi MAY 2009- PSYCHOSURGERY CONSENSUS GROUP MEETING
  9. 9. 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 Doshi PK, Indian J Psych, 2009
  10. 10. Dr. Paresh Doshi WSSFN PSYCHIATRIC FORUM MEETING- SHANGHAI 2011
  11. 11. Dr. Paresh Doshi LONG TERM RESULTS • 62% -1yr • 42% -2yrs • 75% -3yrs Kennedy HS, Lozano et al. Am J Psychiatry 2011; 168:502–510
  12. 12. Dr. Paresh Doshi BEN’S JOURNEY 23rd September, 2013
  13. 13. Dr. Paresh Doshi DAY 1
  14. 14. Dr. Paresh Doshi DAY 2 • Picture of consensus group with names tagged
  15. 15. Dr. Paresh Doshi DAY 3 : FRAME FIXATION
  16. 16. Dr. Paresh Doshi DAY 3: PLANNING
  17. 17. Dr. Paresh Doshi DAY 3: SURGICAL SETUP
  18. 18. Dr. Paresh Doshi DAY3: INTRAOPERATIVE ASSESSMENT
  19. 19. Dr. Paresh Doshi
  20. 20. Dr. Paresh Doshi DAY 3: FINAL REWARD, BEN SMILING!!!
  21. 21. Dr. Paresh Doshi THANK YOU

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