Our Expertise
DBS Surgery
Deep Brain Stimulation (DBS) Surgery at Jaslok Hospital, Mumbai
The Department of Neurosurgery at Jaslok Hospital & Research Centre runs a Deep Brain Stimulation (DBS) programme established in 1998 by Prof. Dr. Paresh K. Doshi. The department has two sets of stereotactic frames, planning stations, MRI and microelectrode recording (MER) equipment.
DBS is a surgical procedure in which a small device, similar to a cardiac pacemaker, is implanted to deliver calibrated electrical impulses to specific regions of the brain. It modulates abnormal brain activity and is considered for patients with certain neurological and psychiatric conditions whose symptoms are no longer adequately controlled by medication alone.
About the DBS Programme
DBS evaluation and post-operative management at Jaslok Hospital involves a Movement Disorder Specialist, Functional Neurosurgeon, Psychiatrist, Neuropsychologist, Urologist, Gastroenterologist and Pain Physician. Parkinson’s disease can affect several organ systems, not only movement, so more than one specialty may be involved in care.
Conditions Considered for DBS
The DBS programme at Jaslok Hospital evaluates the following conditions. All patients undergo a formal multidisciplinary assessment, including neurological, neuropsychological and surgical review, before surgery is recommended.
Parkinson’s Disease
DBS is considered for patients with motor fluctuations, medication-induced dyskinesias, or tremor that is no longer adequately controlled by medication alone. DBS does not cure Parkinson’s disease. It is used to manage symptoms and may allow a lower dose of levodopa.
Essential Tremor
DBS of the thalamus (Vim) is used to treat hand, head and voice tremors. It is considered for patients whose tremor interferes with writing, eating or fine motor tasks.
Dystonia
Generalised, segmental, cervical and focal dystonias, including writer’s cramp, are treated with DBS targeting the globus pallidus internus (GPi). Response may be gradual over several months.
Obsessive Compulsive Disorder (OCD)
DBS is performed for severe, treatment-resistant OCD. The procedure targets the anterior limb of the internal capsule / nucleus accumbens. Candidates are evaluated by a dedicated psychiatric neuromodulation team.
Treatment-Resistant Depression
DBS for depression is evaluated on an individual basis for patients with severe, chronic depression that has not responded to pharmacological and psychological treatments.
Epilepsy
DBS of the anterior nucleus of the thalamus (ANT), known as the SANTE protocol, is considered for patients with medically refractory epilepsy where resective surgery is not appropriate.
Tourette Syndrome
Severe Tourette Syndrome that has not responded to medication may be considered for DBS. Each case is evaluated individually by the multidisciplinary team.
Chronic Pain and Spasticity
Spinal cord stimulation and intrathecal baclofen therapy for spasticity conditions are managed under the same functional neurosurgery programme.
FAQ’s
Q1. What are the risks of DBS surgery?
DBS is a surgical procedure and carries risks, including bleeding within the brain, infection, hardware-related issues such as lead displacement or device malfunction, and side effects of stimulation. The risk-benefit discussion is individualised for each patient during the pre-surgical evaluation.
Q2. How do I know if I am a candidate for DBS surgery?
Candidacy is determined by a formal multidisciplinary evaluation, not by a single consultation. For Parkinson’s disease, the key criteria are a confirmed diagnosis, a clear response to levodopa medication (assessed by formal challenge), adequate cognitive function, and symptoms that are no longer controlled satisfactorily by medication despite optimised dosing. For other conditions, specific criteria apply. The team completes this evaluation before any surgical recommendation is made.
Q3. How long does DBS surgery take at Jaslok Hospital?
The awake lead implantation phase typically takes 3 to 5 hours, depending on the number of leads placed (unilateral or bilateral) and the complexity of the microelectrode recording. IPG implantation, which may be performed in the same session or the following day, takes approximately 1 to 2 hours. The total hospital stay is typically 5 to 7 days.
Q4. What is the cost of DBS surgery at Jaslok Hospital?
The cost depends on the type of DBS system selected (rechargeable or non-rechargeable), the number of leads placed and the patient’s clinical requirements. A detailed cost estimate is provided during the pre-surgical consultation. International patients may request a cost estimate in advance by contacting the programme coordinator. For indicative pricing, please contact +91 99309 90777.
Q5. Can international patients undergo DBS at Jaslok Hospital?
Yes. Pre-operative evaluation can be conducted remotely using available clinical records and imaging. The programme team coordinates medical visa support, airport transfer, accommodation referrals and post-operative telemedicine follow-up. International patients can contact the international patient coordinator at +91 99309 90777.
Q6. Does DBS surgery cure Parkinson’s disease?
No. DBS does not cure Parkinson’s disease or change its underlying progression. It is a symptomatic therapy used to manage tremor, rigidity, slowness of movement and motor fluctuations, and the required medication dose may be reduced. The expected course and possible limitations are discussed with every patient before surgery.
Q7. Can DBS be used for conditions other than Parkinson’s disease?
Yes. The Jaslok DBS programme evaluates Essential Tremor, Dystonia, OCD, treatment-resistant Depression, Epilepsy and Tourette Syndrome in addition to Parkinson’s disease. Each condition has specific candidacy criteria. Please contact the programme team to discuss whether DBS may be appropriate in your situation.
Q8. What happens if DBS does not work adequately after surgery?
DBS programming is an iterative process that may take several months. If initial programming does not achieve the expected benefit, the team re-evaluates lead placement, programming parameters and concomitant medication.
What Differentiates Us
India's longest-running DBS programme — The Jaslok DBS programme was established in 1998, when Prof. Dr. Paresh Doshi performed India's first Deep Brain Stimulation surgery. No other centre in India has an unbroken institutional history of DBS spanning 30 years. This longevity translates directly into depth of experience — in patient selection, surgical technique, intraoperative decision-making, and the long-term management of patients living with DBS devices.
The only centre in India with two complete sets of stereotactic equipment — Jaslok Hospital maintains two full stereotactic surgical setups, each comprising stereotactic frames, planning stations, dedicated MRI, and microelectrode recording (MER) equipment. No other hospital in India has this level of surgical infrastructure redundancy. This means patients face no delays due to equipment scheduling, and there is intraoperative backup if any technical issue arises during surgery.
A genuinely multidisciplinary team — DBS evaluation and post-operative management at Jaslok involves more than a neurosurgeon and neurologist. The team includes a Movement Disorder Specialist, Functional Neurosurgeon, Psychiatrist, Neuropsychologist, Urologist, Gastroenterologist, and Pain Physician — all specialists with more than 15 years of experience managing DBS patients. This breadth of expertise is essential for managing the full spectrum of Parkinson's disease, which affects multiple organ systems, not only movement.
30 years of patient follow-up data — Some of Jaslok's earliest DBS patients, operated in 1998, continue to attend follow-up clinics at the hospital. This unbroken longitudinal outcome data — unique in India — informs every aspect of patient selection, programming strategy, and long-term management at the centre.
International patient experience — Patients from the Middle East, East Africa, South-East Asia, and the United Kingdom have undergone DBS evaluation and surgery at Jaslok. The team is experienced in coordinating care for international patients, including pre-operative evaluation remotely, travel and accommodation support, and post-operative programming via telemedicine.
Awake surgery with microelectrode recording (MER) — The Jaslok team performs DBS under local anaesthesia with intraoperative MER and clinical testing. This approach — requiring the patient to remain awake and responsive during surgery — allows real-time verification of electrode placement based on neuronal firing patterns and immediate clinical response, reducing the risk of suboptimal lead positioning.
Key Technologies
DBS Process at Jaslok Hospital
1. Multidisciplinary Evaluation
Every DBS candidate undergoes a structured pre-surgical evaluation involving the Movement Disorder Neurologist, Functional Neurosurgeon and Neuropsychologist. The evaluation assesses medication response (including a formal levodopa challenge for Parkinson’s patients), cognitive function, psychiatric status and surgical fitness. Not all patients referred for DBS proceed to surgery.
2. Neuroimaging and Surgical Planning
MRI is performed for stereotactic target planning. The surgical team uses stereotactic planning software to map the anatomical target, such as the subthalamic nucleus (STN), globus pallidus internus (GPi), thalamus (Vim) or other targets depending on the indication, before surgery begins.
3. Awake Surgery with Microelectrode Recording
DBS surgery at Jaslok Hospital is performed under local anaesthesia. The patient remains awake and conversant, which allows the surgical team to correlate microelectrode recording (MER) data with the patient’s neurological response. Lead placement is checked electrophysiologically and clinically before the electrode is fixed. The pulse generator (IPG) is implanted under the skin of the chest in the same surgical session or on the following day.
4. Programming and Follow-up
After surgery, DBS programming clinics are held where stimulation parameters are adjusted over weeks and months to manage symptoms and side effects. Medication is adjusted at the same time.
Key Procedures
Our Experts
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