Now, a pace-maker for the brain

One needn't look westward these days to cure a disabling ailment like Dystonia - a neurological disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. The Deep Brain Stimulation (DBS) procedure, which provides relief to these patients, is very much accessible within our country.

Four Indian hospitals offer the procedure: Delhi's All India Institute of Medical Sciences (AIIMS), Mumbai's Jaslok Hospital, Hyderabad's NIZAMS and Srichitra Institute in Thiruvananthapuram. The neurosciences department at AIIMS offers this treatment at minimal price.

Only a handful of hospitals around the world (five in the US and three in the UK) offer this procedure at almost 10 times cost. "This surgery is for those patients for whom we have nothing more to offer in terms of medicines or injections," said Dr Vinay Goyal, associate professor of neurology at AIIMS, who sees about 20 Dystonia patients every week.

Deep brain stimulation is a surgical procedure involving the implantation of a device called a pacemaker, which sends electrical signals to a specific part of the brain. Like the heart's pacemaker, this device - a battery - functions like the pacemaker of the brain.

The battery is implanted near the shoulder and sends signals through a wire connected to electrodes placed at the area of the brain that is most affected. All components are surgically implanted inside.

"In Dystonia there are a lot of involuntary movements. The high frequency stimulation stops those involuntary movements," said Dr Aditya Gupta, associate professor of neurosurgery at AIIMS, who conducts most of the surgeries.

The last and most important part of the procedure is programming the device. "You have to programme the device in such a way that it sends right amplitude and frequency of current to give desired results," said Gupta.

For each patient, the amplitude and the frequency may differ. Dystonia is a genetic disorder caused by the DYT1 gene.

Normally used to treat tremors caused by Parkinson's disease, the procedure is now gaining popularity among Dystonia patients as well. AIIMS has operated on three cases of dystonia in the past three years.

The most recent, 22-year-old Baby Kumari from Bihar, was operated on February 4.