Times of India
09 February 2011
By Pratibha Masand
Mumbai, India

alternate Parkinson’s cure
Lesion Made In Patient’s Brain To Kill Affected Cells
Sixty–one–year–old Purshottam Dadhania is a happy man today. He can walk, eat and button his shirt himself, difficult even a week ago. Dadhania was suffering from Parkinson’s disease, a condition which city doctors treated with a method not commonly used on such a patient.

The Ahmedabad resident and retired teacher showed symptoms of Parkinson’s seven years ago. "He would get tremors. His body would go rigid and fingers and toes would curl up. He couldn’t stand, walk or lie down. He would have such spasms it required three people to hold him," said his son Paresh.

His condition worsened so he wanted to commit suicide. "I would take 20 pills a day including sleeping pills almost every alternate night. I didn’t want to live a life of constant dependence on my family. I even told them to donate my organs," said Purshottam.

A deep brain stimulation (DBS), the norm in treating Parkinson’s disease, was unaffordable for the family. But after doctors in Ahmedabad confirmed there was nothing they could do apart from DBS, which would have cost above Rs 6 lakh, he was brought to Jaslok Hospital here. "We studied his case. The only treatment for him was the DBS. But the family couldn’t afford it. So, we decided to go ahead with the subthalamic nucleus (STN) lesioning," said Dr Paresh Doshi, consultant neurosurgeon at Jaslok Hospital, adding he became the first Indian to undergo this therapy.

On February 4, under local anaesthesia, Purshottam underwent the therapy in which an electrode was inserted in the affected area (subthalamic nucleus) in his brain. With the help of a radio frequency lesion generator, heat was passed to the tip of the electrode, which killed cells causing the disease. "Instead of implanting electrodes in the subthalamic nucleus, the area in the brain which causes the problem, we created a small lesion in the region and killed cells causing symptoms of Parkinson’s disease. While his symptoms would have been controlled by the battery–operated electrodes had we done a DBS, he is now in complete control of himself," said Dr Doshi. It cost him Rs 1.70 lakh.

Other neurosurgeons however, are sceptical. "Lesions are done very commonly for a number of problems like dystonia (involuntary contractions of muscles) and some psychiatric disorders. There is nothing out of ordinary about treating brain–related problems with lesions," said Dr Atul Goel, neurosurgeon at KEM hospital.

Dr Keki Turel, head of neurosurgery in Bombay Hospital, said an STN lesion therapy is more complicated than DBS and thus rarely attempted. "A DBS is reversible if anything goes wrong. But an STN lesion is an irreversible process. A slight digression from the target and the patient can suffer from a horde of other problems than Parkinson’s. So it is rarely attempted," he said.
Luckily for Purshottam, life is back to normal.

About The Disease

• Parkinson’s Disease is the degenerative disease of the brain (central nervous system) that leads to shaking (tremors) and difficulty with walking, movement and coordination
• It is caused by dopaminergic neurons, cells in the brain that release dopamine, a chemical involved in communication of information from one neuron to another and finally to the muscles