Appeal In Bombay HC to Allow Deep Brain Stimulation Surgery For OCD: What Is It?

Doctors explain whether Deep Brain Stimulation surgery will actually help those suffering from OCD.

What is Deep Brain Stimulation Surgery (DBS), and what role does it play in a disorder like Obsessive Compulsive Disorder (OCD)?

(Photo: The Quint)

"I have OCD, I love to clean" – a phrase used quite casually by many who might not understand the complexity of the disorder.

The story of a 24-year-old girl from Hyderabad suffering from Obsessive Compulsive Disorder (OCD), who had moved to Mumbai to pursue her dreams, is one of those cases where we realise that it's not as simple as one might think.

The young girl had locked herself in a room, spent her entire time just cleaning the house constantly, while giving up eating food and drinking water at all.

The girl’s father has now appealed to the Bombay High Court demanding to allow him to get Deep Brain Stimulation Surgery (DBS) performed on his daughter to save her life. The petition has been filed in the court for this surgery as is mandatory to get the approval of a medical board for this psychosurgery.

But what is Deep Brain Stimulation Surgery (DBS)? What role does it play in a disorder like Obsessive Compulsive Disorder (OCD)? To understand this among other things we spoke to Dr Sanjay Pandey, Head, Department of Neurology, Amrita Hospital, Faridabad, and Vasundhra Choudhary, clinical psychologist.

What is OCD, really?

Obsessive Compulsive Disorder (OCD) is part of the neurotic, stress-related and somatoform disorders in the International Classification of Diseases (ICD) 10.

Clinical Psychologist Vasundhra Choudhary says "usually, people refer to OCD with being excessively clean and detail oriented. The term is used very casually, when in fact, it is a very disabling disorder."

OCD has two parts:

• Obsession

• Compulsion

An obsession is an impulse or image which intrudes into the conscious awareness repeatedly. It is a recognised as product of our own mind. It is seen as irrational and absurd and the person tries to resist it which is very distressing to the person suffering.

Another part of OCD is compulsions which are the specific behaviours, that help reduce the anxiety the obsessions are producing.

Therefore, a person becomes very occupied with these compulsions and spends excessive time on them.

What is Deep Brain Stimulation (DBS)?

Deep brain stimulation is a surgical procedure that involves implanting electrodes within certain areas of the brain. These electrodes produce electrical impulses that can affect certain cells and chemicals within the brain.

The amount of stimulation is controlled by a pacemaker-like device that is placed under the skin in the upper chest.

When is DBS usually used?

Deep brain stimulation is used to treat several conditions such as Parkinson's disease.

While this surgery is normally considered to be low risk, like any kind of surgery, this too has the risk of complications. It is however, also used in the following cases:

• Essential tremor

• Dystonia

• Epilepsy

It is also being studied as a potential treatment for:

• Tourette syndrome

• Huntington's disease and chorea

• Chronic pain

• Cluster headache

When can DBS be used for the treatment of OCD?

Medical professionals opt for DBS for the treatment of OCD patients when the severity of the illness is a bit extreme to be treated through medication only.

It is effective for more the 50 percent of the patients who go through this treatment. However, it is only used after intense medical advise and scrutiny.

"Brain scans help us locate the part of your brain that is causing your symptoms. We implant two electrodes into that area. We also implant a neurostimulator, a small device similar to a pacemaker, that delivers mild electrical signals. We put the device near your collarbone. Then we connect the electrodes, which carry the electrical current to the neurostimulator. This system lets us send electrical signals to your brain, which helps with your OCD symptoms," Martijn Figee, a neurosurgeon in Mount Sinai, New York, has explained the procedure earlier.

What are the side effects of DBS?

• Seizure

• Infection

• Headache

• Confusion

• Difficulty concentrating

• Stroke

• Hardware complications, such as an eroded lead wire

• Temporary pain and swelling at the implantation site

But is it a common procedure in India?

No, the procedure is not very common in India to treat OCD, say doctors.