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

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. Dr. Paresh Doshi
FIRST CASE IN ASIAN- AUSTRALIAN
CONTINENTS

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. Dr. Paresh Doshi
DEEP BRAIN STIMULATON

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. 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. Dr. Paresh Doshi
WHY SCCG
Inc activity in
depression

8. Dr. Paresh Doshi
MAY 2009- PSYCHOSURGERY CONSENSUS
GROUP MEETING

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. Dr. Paresh Doshi
WSSFN PSYCHIATRIC FORUM MEETING-
SHANGHAI 2011

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. Dr. Paresh Doshi
BEN’S JOURNEY
23rd September, 2013

13. Dr. Paresh Doshi
DAY 1

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DAY 2
• Picture of consensus group with names tagged

15. Dr. Paresh Doshi
DAY 3 : FRAME FIXATION

16. Dr. Paresh Doshi
DAY 3: PLANNING

17. Dr. Paresh Doshi
DAY 3: SURGICAL SETUP

18. Dr. Paresh Doshi
DAY3: INTRAOPERATIVE ASSESSMENT

19. Dr. Paresh Doshi

20. Dr. Paresh Doshi
DAY 3: FINAL REWARD, BEN SMILING!!!

21. Dr. Paresh Doshi
THANK YOU