Friday, November 13, 2009

Probing into Depression - Research Blogging / by Dave Munger

Cool - there has been research into deep brain stimulation for quite some time, and it looks like it's starting to show promise for clinical depression that does not respond to drugs and might otherwise require ECT.

Probing into Depression

Research Blogging / by Dave Munger / November 11, 2009

Deep brain stimulation, already established as a treatment for stubborn Parkinson’s disease, may also be useful as a therapy for drug-resistant clinical depression.

What would it take for you to allow a surgeon to probe deep into your brain to implant permanent electrodes that would administer behavior-altering electric shocks? Anyone undergoing brain surgery risks stroke and possibly death, and even if the surgery is successful there is the potential for infection, which would require even more surgery with all its attendant risks.

Tens of thousands already have electrostimulation devices implanted in their brains, and millions more may join them if the technique, called “deep brain stimulation” (DBS), gains wider acceptance. DBS was originally developed as a treatment for Parkinson’s disease, and it has been remarkably effective. The primary symptom of Parkinson’s is uncontrollable body tremors that can make it nearly impossible to perform basic daily functions like eating and drinking, writing, and even walking. An acquaintance of mine who has Parkinson’s opted for the DBS procedure and now functions perfectly normally—it’s impossible for the casual observer to notice anything unusual about how he moves. He went from being nearly incapacitated to being renewed as a healthy, fully functional person. Perhaps it’s no wonder that he was willing to submit to such an invasive procedure.

In DBS therapy, one or more electrodes the size of a spaghetti strand are precisely positioned in the patient’s brain, then connected by wire around the skull and through the neck to a pacemaker-like device, a neurostimulator, just below the collarbone. The neurostimulator is activated and deactivated by a magnet that the patient carries, so if a tremor is beginning to become disruptive, DBS can be self-administered in an instant, with near-instantaneous results. A video provided by the manufacturer of a DBS device shows how it works in ideal cases.

Now new uses for the treatment are being tested. One observed side effect of DBS for Parkinson’s is excessive happiness, to the point of uncontrollable elation—the sort of unhealthy, personality-changing reaction that everyone fears when they think of electrodes being implanted in their brain. Tuning the device can minimize this side effect, but its very existence suggests that DBS might be a useful therapy for clinical depression.

Read the rest of the article.

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