‘Pacemaker for the brain’ cures untreatable depression

This may be the turning point that mental illness has been waiting for for years.

Unfortunately, stress is a common problem. Fortunately, a psychologist or psychiatrist can often help. But for a small proportion of patients, behavioral therapy or medication may not be enough; They suffer from severe and untreatable depression. And Sarah (his last name was omitted at his request). “I was at the end of my rope. I was very stressed (…) This is not a life worth living.” But thanks to the work of researchers at the University of California (San Francisco), her situation has changed abruptly and drastically. After many years of failed treatments, her depressive symptoms have finally subsided. “At first there was a lot of emotion and darkness, but now I get up and go about my day.”

Thanks to a small device fitted to her brain – when needed – it stimulates a specific part of her brain. A kind of pacemaker, but to the brain.

Deep brain stimulation
This is not the first time researchers have used what is known as deep brain stimulation in an effort to reduce or correct depressive symptoms. But previous attempts have been limited or otherwise successful. Most brain implants used for this purpose continuously emit electrical signals and can often only be used on one brain area. The latter is difficult because the areas of the brain that produce depressive symptoms vary from person to person.

Reason enough for American researchers to develop a different approach. The result is brain implantation, which stimulates the brain only when it needs it and focuses on the area of ​​the brain as well.

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As mentioned, one person’s depressive symptoms may arise from different areas of the brain than others. Effective deep brain stimulation aims to correct depressive symptoms, so you need to determine which part of the brain responds best to the stimulus in each patient. The researchers placed ten electrodes on different parts of the brain, lightly stimulating those parts of the brain, and looking at how the patient responded. In Sarah’s case, stimulation of the ventral striatum was found to greatly improve mood. With that, the researchers discovered a part of the brain that they could trigger. But they only wanted to stimulate that part of the brain when it was really needed, that is, when it threatened to worsen her mood. That too is possible. Researchers have shown that the onset of depressive symptoms coincides with a specific pattern of brain activity, especially measured in the amygdala. The researchers developed a brain implant that constantly measures the activity of the brain in the amygdala and, when an abnormal pattern is detected, stimulates the striatum ventral.

The results are interesting. “We were able to offer this suture treatment to a patient with depression and were able to alleviate her symptoms,” said research researcher Catherine Skangos. Depression can take weeks after standard treatments to subside, and Sarah has noticed almost immediate results. Fifteen months have passed since the implant was placed, not just shortly after the implant was made. “In the first few months, the stress suddenly subsided and I didn’t know it would stay that way,” Sarah said. “But it remains so. And I realized that this tool improves the therapy and self-care I have learned to practice.

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The future
Of course, there is hope that more people with ‘incurable depression’ can be treated in the future. “The idea that we can treat when symptoms appear is a new way to deal with the most difficult cases of depression,” Scongos said.

But more research is needed before making this treatment widespread. The clinical trial is currently being expanded to include two new patients and will soon be followed by nine. Follow-up research should also show whether the approach works for others in the long run. Scientists hope to gain more insight into the areas of the brain associated with depression. This can lead to completely new therapies in which the function of these areas of the brain can be adjusted to a less severe level.

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