A study on brain stimulation deep in USP Sagrado Corazón, Award Best Ideas 2011 of Diario Médico.

brain stimulation profound, revolutionary technique of functional neurosurgery, applies in the case of psychiatric disorders that do not respond to medication to stimulate certain brain areas involved in the production of the symptoms of certain diseases. The Stimulator, which is connected to electrodes, makes the functions of a pacemaker and can be programmed and controlled from abroad.

The surgical technique, involves the implantation of electrodes in the nodes of the base, by neuronavigation and stereotactic – surgical minimally invasive technique – assisted surgery; the electrodes are connected to a stimulator makes the functions of a pacemaker programmed and controlled externally.

Advantages of the technique

The main advantages are that it is a reversible process, that allows to adjust the parameters of stimulation according to the requirements of the patient and that presents few complications to be minimally invasive.

This technique is widely proven and already has been used for the treatment of disorders of the movement, such as Parkinson’s or tics. Its use is also increasing in chronic neuropathic pain, certain headaches and epilepsy. In the field of psychiatry has its indication in obsessive-compulsive disorder, depression and aggressiveness, which do not respond to medication. As you can imagine these pathologies condition an important social and labour involvement in common

Two patients operated successfully

So far have been operated with this new technique two patients on USP Sagrado Corazón, the first featured a compulsive obsessive syndrome and the second a pattern of aggressiveness. The result of interventions, in both cases, has been highly satisfactory, sending much of symptoms and allowing better programming and dosage of the medication

Obsessive-compulsive disorder

Neuropsychiatric disorders of obsessive type – compulsive, are highly disabling, incapacitating in many cases, social and employment for people with this disorder and creating a huge social burden to families, the more cases that don’t respond to medication.

It is estimated that 2% of the population suffers from an obsesivos-compulsivos disorders and that approximately 10% of these do not respond to medication. Deep brain stimulation of areas known as internal capsules has proved to be an alternative in these patients because it manages to reduce significantly the obsession, the compulsions and the anxiety and depression these condition; and improve the quality of life.

Obsessive-compulsive disorder is the presence of obsessions that lead to compulsive acts. Obsessions are recurrent, without sense and involuntary thoughts. The compulsions are repetitive acts that turn into rituals aimed at avoiding the obsession and anxiety that it generates. Typical compulsions tend to be the wash hands repeatedly, check if one closed door again and again, count, or sort a rigid and particularly, for example. This disorder can completely dominate the life of the patient for ideas and compulsions are inevitable.

Depression

Depression has become the major source of disability over the 50 years in United States and is known that, like that in obsessive-compulsive disorder, approximately 10% of patients do not respond to medication. In those patients that are not associated manic episodes as a result of bipolar disorder, ideas suicidal or psychotic symptoms can be used for stimulation, in this case of a medial zone of both frontal lobes, with a very good and response maintained at the time in two of every three patients.

Multidisciplinary team

The application of this technical neurosurgical, has meant an enormous progress in severe cases of neuropsychiatric diseases without response to medication and in adapting to the daily life of patients who suffer from.

For the implementation of this technique is required a multidisciplinary team, the team of neurosurgery of USP Sacred Heart-IENSA, it is reference in neurosurgery at national and international level, being pioneers in various surgical techniques, such as surgery for the treatment of epilepsy, topic on which have numerous publications, as well as in the implementation of the first resonance magnetic Intraoperatoria of our country, applied to the surgical treatment of brain tumors.