Gurugram: A 28-year-old man suffering from Schizophrenia from 13 years of age, became the first to undergo surgery for schizophrenia in India. In a path-breaking effort, the Neurosurgery team at Marengo Asia Hospitals Gurgaon successfully treated this patient through Nucleus Accumbens - Deep Brain Stimulation surgery.
This was the first surgery performed in India, for schizophrenia, a debilitating mental illness. *This was led by Dr Himanshu Champaneri, a senior consultant neurosurgeon at the Marengo Asia Hospitals Gurugram.
This ground-breaking procedure, which has been performed only 13 times globally, marks a remarkable advancement in the psychiatric surgery (psychosurgery) field.
Schizophrenia, a complex psychiatric disorder, affects millions of people worldwide, and finding effective treatment has been a challenging endeavor.
*The patient, a man from Africa (identity kept confidential), had been diagnosed with schizophrenia at the age of 15 years*. Despite undergoing various medication regimens, he had been experiencing persistent hallucinations and delusions among other symptoms of schizophrenia. He had isolated himself in his room for eight years, severely impacting his quality of life, his social life, and his academic growth since he dropped out of school.
The patient's symptoms of schizophrenia had progressively worsened over the years, manifesting in complete social withdrawal. He became increasingly resistant to the prescribed medicines. The condition began to significantly impact the patient's ability to function in daily life. And he became increasingly resistant to the prescribed medicines when he chose to come to India for an enhanced treatment called neuromodulation.
Driven by the desire to provide the best possible care, the patient's father sought the expertise of Dr Himanshu Champaneri, after learning about the possibilities of a neurosurgical intervention that could improve his son’s condition and restore normalcy in his life. The patient was referred to psychiatrists and evaluated meticulously to analyze the treatment options. After weighing all the treatment alternatives, the patient was considered for DBS surgery. In accordance with the Mental Health Act 2017, India, approval was taken from the government mental health review board to perform this psychosurgery.
The patient was operated on 14 June 2023, and the outcome of this DBS procedure has been remarkable. The patient has currently shown promising outcomes with significant symptom reduction and overall improvement in his condition.
*Dr Himanshu Champaneri, Senior Consultant Neurosurgeon, at Marengo Asia Hospital Gurugram said*, “Deep Brain Stimulation (DBS) is an evolving surgical technique that involves the implantation of electrodes into specific areas of the brain. These electrodes deliver electrical impulses to regulate abnormal brain activity and restore balance. The entire procedure took 8-10 hours and the patient was monitored in ICU overnight.
On day 2 postoperatively, he was able to walk and also felt 50-60% improvement in his symptoms. On day 10, he feels 80% reduction in his hallucinations, delusions and anxiety. DBS acts by modulating the abnormal brain networks, so the patients are expected to improve further, with the passage of time. While DBS is primarily known for its application in movement disorders such as Parkinson's disease, its potential in treating psychiatric disorders, including schizophrenia, appears promising.”
Dr Champaneri further added, “The advantages of DBS surgery lie in its ability to offer a personalized approach to treatment. By targeting specific regions of the brain, DBS can potentially alleviate symptoms and improve the patient's quality of life when traditional medications and therapies prove insufficient. The target chosen in schizophrenia is called Nucleus Accumbens, which is responsible for the patient’s symptoms like hallucinations and delusions.”
*Dr Raajiv Singhal, Managing Director & Group CEO Says*, “At Marengo Asia Hospitals, our clinicians constantly endeavor to break the ceiling to go beyond borders to treat patients who come to us. In the entire scope of health and wellness, looking after our mental health is as important as physical health. Both are interconnected, and one determines the well-being of the other.
Despite variations in studies, the data available in India suggests that about 20% of the adult population suffers from one or other mental health issues. Mental health is fast emerging as an increasing cause of concern the world over. In our aim to create an ecosystem of clinical corridors to facilitate medical value tourism Marengo Asia Hospitals extend the best treatment solutions with super-specialists in the ecosystem of healthcare.”
WHO studies estimated that the burden of mental health problems in India is 2443 disability-adjusted life years (DALYs) per 100 000 population; the age-adjusted suicide rate per 100 000 population is 21.1. The economic loss due to mental health conditions, between 2012-2030, is estimated at USD 1.03 trillion.
It is estimated that 6-7 % of the population suffers from mental disorders. The lifetime incidence of schizophrenia is 1.4% in the Indian population. It is a serious condition with multitude of problems including social isolation and stigmatization. The awareness for which is still very low even in the literates.
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