- Scientists use deep brain stimulation (DBS) on woman with severe depression
- 36-year-old shows ‘rapid and continuous improvement’ in depression severity
- DBS has already been used to treat dementia, Parkinson’s, Tourette’s, and others.
- It could also be a promising step towards personalized psychiatric treatment.
The results of pioneering experiments suggest that depression may soon be treated by patting your brain.
Scientists in California performed deep brain stimulation (DBS) on a 36-year-old woman with severe depression who was unresponsive to other treatments.
DBS is a medical procedure where implanted electrodes deliver electrical impulses to other implanted structures, such as ‘pacemakers for the brain’.
After treatment, the woman showed a ‘rapid and sustained improvement’ in the severity of depression, the researchers report.
The proof-of-concept – which involves targeting unique brain patterns for each patient – suggests that brain activity could be used to deliver personalized treatments for difficult-to-treat neuropsychiatric disorders.
Sarah, Patient in Clinical Trial, on appointment with Dr. Katherine Scangos at the University of California, San Francisco (UCSF) Langley Porter Psychiatric Institute
Sarah, pictured, was already unresponsive to multiple antidepressant combinations and electroconvulsive therapy
What is Deep Brain Stimulation?
Deep brain stimulation (DBS) helps control movement problems and is the main type of surgery used to treat Parkinson’s.
It involves implanting very fine wires with electrodes at their ends into the brain.
These are attached to extensions under the skin behind the ear and down the neck, which are then connected to a pulse generator.
When the device is turned on, electrodes deliver high-frequency stimulation to the targeted area, which alters the signals in the brain that cause Parkinson’s symptoms.
The brain is not destroyed in this process.
DBS is usually reversible.
It does not stop the progression of Parkinson’s and there is no cure for it.
Source: Parkinson’s UK
The new research took place at the Langley Porter Psychiatric Institute, part of the University of California, San Francisco (UCSF).
The research team, led by UCSF neuroscientist Katherine Skangos, says the therapy has resulted in rapid and sustained improvement in depression.
‘Future work is needed to determine whether this n-of-1 results and approach’ [single patient] Study the generalization to the wider population.’
DBS is a relatively new procedure that uses electrical communication between two components implanted in the body—an electrode containing multiple contact points, implanted in the brain, and a programmable pulse generator, implanted somewhere under the skin. Is.
Both are connected by cables that also pass under the skin. When the generator is turned on, the electrodes deliver high-frequency stimulation to a target area in the brain, blocking the signals that cause symptoms.
DBS has already been used to treat dementia, Parkinson’s disease, Tourette’s syndrome, and muscle spasms.
But previous clinical trials have shown limited success for treating depression with conventional DBS, as most devices can only provide continuous electrical stimulation, usually to only one area of the brain.
What made this clinical trial a success was the discovery of a neural biomarker — a specific pattern of brain activity that signals the onset of symptoms — and the team’s ability to adapt a new DBS device to respond only when it Recognizes that pattern.
The UCSF researchers claim that the device then stimulates a different area of the brain circuit, creating on-demand immediate therapy that is ‘unique to both the patient’s brain and neural circuits’.
For the new experiments, the team recruited 36-year-old Sarah, who asked to be referred only by her first name.
She suffered from severe and treatment-resistant major depressive disorder (MDD) in childhood and was already unresponsive to multiple antidepressant combinations and electroconvulsive therapy.
Illustration from research paper Shows Implantable Sensing and Stimulation Deep Brain Stimulation (DBS) System
What is depression?
Although it is normal to feel sad from time to time, people with depression can feel sad continuously for weeks or months.
Depression can affect anyone at any age and is quite common – about one in ten people are likely to experience it at some point in their life.
Depression is a real health condition that people can’t just ignore or ‘get out of’.
Symptoms and effects vary, but can include feeling persistently upset or hopeless, or losing interest in things you used to enjoy.
It can also cause physical symptoms such as trouble sleeping, feeling tired, low appetite or sex drive, and even physical pain.
In extreme cases it can lead to suicidal thoughts.
Traumatic events can trigger it, and people with a family history may be at greater risk.
It’s important to see a doctor if you think you or someone you know has depression, as it can be managed with lifestyle changes, therapy, or medication.
Source: NHS Choices
‘I was at the end of the line,’ she said. ‘I was very sad. I couldn’t see myself continuing if I could only do that, if I couldn’t move on. It was not a life worth living.’
The authors first identified specific brain-activity patterns in the patient that were closely related to the severity of their depressive symptoms.
A commercially available implanted neural interface – capable of sensing brain activity and providing electrical stimulation – was then used to deliver stimulation when a condition of high depression severity was detected.
This therapy resulted in rapid and sustained improvement in depression, the researchers report in their paper,…