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POST TIME: 25 September, 2017 00:00 00 AM / LAST MODIFIED: 24 September, 2017 10:25:51 PM
Deep brain stimulation: a light of hope for Parkinson’s patients
Dr. Khondaker A. Mamun

Deep brain stimulation: a light of hope for Parkinson’s patients

In Bangladesh, every year,
approximately
1600 patients die from Parkinson's disease while many more suffering from it

Human brain is a scientific wonder and a perplexing mystery at the same time. Even with amazing advancement of medical sciences, the level of knowledge about this vital centerpiece organ is inadequate and scientists still don’t seem to have a good handle about neurological disorders that stem from it. Since the brain plays the master controller of the whole human body, it is hardly surprising that the slightest amount of disorder occurring in it can have serious physical consequences. The commonly experienced neurological disorders span from migraines to strokes, dementia and Parkinson’s disease among others.

Among these the Parkinson's disease attracted great attention when the greatest sports person of last century, Mohammad Ali, suffered from it for a prolonged period of time. Even before that, this special kind of neurological disorder has been known to affect the lives of thousands. Parkinson's disease is a form of progressive movement disorder that has a wide range of debilitating effect on the patients including tremor, lack of balance and coordination to name a few.

The root cause of this disease lies in the malfunction of neurons in a specific location of the brain. More than 10 million people worldwide are living with Parkinson's disease. In Bangladesh, every year, approximately 1600 patients die from this disease while many more suffering from it.

Currently there is no cure for Parkinson's disease. Treatment of Parkinson's disease is, therefore, mainly concerned with controlling the symptoms, which is initially achieved via medication. However, the most prevalent treatment, lepadova therapy, causes the patient to suffer from long term complications.

The next step is surgery. There are two options with regards to surgery. The first one is Lesion therapy. With recent advances in imaging technology and electrophysiological techniques, we can accurately identify and destroy target structures host to the disorder deep in the brain.

 The most advanced option now is Deep Brain Stimulation, where electrodes are placed deep inside the brain connected to an external device and used to stimulate the brain with an aim of stabilizing its output. Functionally it is similar to a pacemaker that regulates electrical impulses for the heart. An electrode is placed surgically deep inside the brain around the Thalamus region.

The electrode is connected to an external stimulator called Neuro-stimulator through an extension wire.

The stimulator is placed under the skin around shoulder and collarbone region. The electrical impulses from the stimulator are transmitted to the electrode that then distributes the impulses to diminish the electrical signals from the neurons in the target area giving rise to Parkinson's disease sysmptoms.

In south Asia, and Bangladesh in particular, Deep Brain Stimulation is still a relatively unexplored path. The complicated procedure means that sufficient skill training is required before a surgeon can attempt this procedure. This has caused a gap in the demand and supply dynamic, resulting in patients from Bangladesh going to Singapore or India to perform this procedure.

Fortunately, times are changing, and some of the most renounced people in the field of Deep Brain Stimulation are going to be in Bangladesh in this month of September, to attend IBRO-APRC Bangladesh Associate School of Translational Neuroscience and Research, organized at United International University from Sep 23-27.

IBRO, or International Brain Research Organization, the premier organization in the world for research on human brain, is the sponsor of this workshop, and participants have been chosen from the Asia Pacific region through a highly competitive selection process. Brain researchers will intermingle with surgeons, and academicians in order to form an interdisciplinary expert body, to jump start the Deep Brain Stimulation scene in Bangladesh.

As a part of the workshop, world renounced neurosurgeon Prof. Tipu Aziz of Oxford University, one of the top neurosurgeons for Lesion and Deep Brain Stimulation, with more than 25 years of experiences, will interact with Neurologists, Neurosurgeons of Bangladesh at NINS, BSMMU and DMC to explain lesion and Deep Brain Stimulation.

Our health sector has already experienced many pioneering medical treatment innovations, and hopefully the transfer of knowledge from such luminaries will motivate the highly talented neurosurgeons and neurologists in Bangladesh to embrace and improve Deep Brain Stimulation techniques. With increasing life expectancy, the number of Parkinson's disease patients is also increasing steadily. Success of this venture to bring cutting edge medical services to these patients will certainly be another defining moment in this sector.

The author is director, AIMS Lab and Associate Professor, United International University