A ‘Pacemaker for the Brain’: Successfully treated for severe depression
Woman successfully treated for
depression with electrical brain implant.
Deep brain stimulation is a
promising treatment for neuropsychiatric conditions such as major depression.
It could be optimized by identifying neural biomarkers that trigger therapy
selectively when symptom severity is elevated.
An electrical implant that sits in the skull and is wired to the brain
can detect and treat severe depression, US scientists believe after promising
results with a first patient. A woman with severe depression has been
successfully treated with an experimental brain implant in a “stunning” advance
that offers hope to those with intractable mental illness.
The therapy would only ever be
suitable for those with severe illness – the success is seen as hugely
significant. It is the first demonstration that the brain activity underlying
the symptoms of mental illness can be reliably detected and reveals that these
brain circuits can be nudged back into a healthy state, even in a patient who
has been unwell for years.
Between 10% and 30% of people with depression do not respond to at least two drug treatments. During the past two decades, deep brain stimulation (DBS) has been used to treat tens of thousands of patients with Parkinson’s disease and epilepsy.
How it works
The device works by detecting patterns of brain activity linked to depression and automatically interrupting those using tiny pulses of electrical stimulation delivered deep inside the brain.
In an initial phase lasting a
week, a temporary brain implant recorded a wide range of activity while patient
regularly logged her mood on a tablet. A machine learning algorithm was used to
identify a telltale pattern of activity in the amygdala region accompanying patient’s
lowest points.
Through trial and error the
scientists identified a closely connected brain area, the ventral striatum,
where a tiny dose of electricity appeared to have an immediate and profound
impact.
In a second round of minimally
invasive surgery, a permanent device was implanted, with a tiny battery unit
embedded in her skull, to detect the “depression signature” activity in the
amygdala and automatically deliver stimulation to the ventral striatum.
This happens about 300 times each
day, equivalent to about 30 minutes of stimulation.
Personalized treatment
There is also need for
personalization via temporally controlling stimulation as in closed-loop
neuromodulation, where a patient’s own physiological activity is used to
selectively trigger stimulation only when a pathological state is detected.
Because the mood-related effects
of neuromodulation exhibit state dependence.
Future work is required to determine if the results and approach of this n-of-1 study generalize to a broader population.
Source:
Comments
You must login to write comment