Question:
Depression Treatment breakthrough?
Answer:
A team of Toronto researchers says it may have found a way to offer hope to
the millions of people suffering long-lasting clinical depression who have
been resistant to conventional treatment.
The researchers say they have had promising results from a study on deep
brain stimulation (DBS). The researchers believe the method acts as a "brain
pacemaker" to make depressed people happy again by electronically
stimulating the brain.
The experiment is thought to be the first demonstration of drug-free
electronic mood control.
The researchers behind the study emphasize more trials are needed but hope
the method could offer a new therapy for millions suffering clinical
depression who have not responded to drugs, psychotherapy, or
electroconvulsive therapy.
For the study, patients with untreatable clinical depression had electrodes
surgically implanted deep in their brains to stimulate the brain's the
subgenual cingulate region -- one of the areas involved in mood control.
The patients then had a pulse generator implant -- the pacemaker -- sewn
under the skin in their chest. The wires were hooked up to provide constant
brain stimulation.
The results have been described by those involved as "like a miracle."
All six volunteers reported acute effects once the current was switched on,
including noticing a sudden brightening of the room and a sense of
heightened awareness.
Significant clinical response was seen in four of the six study subjects,
with sustained improvement through six months.
Before the treatment, the patients were deeply depressed, lacking
motivation, refusing to get out of bed for days and often feeling suicidal.
"These people weren't just having a bad day," explained Dr. Helen Mayberg, a
neurologist who led the research. "They were beyond suicidal; they were too
apathetic and disengaged to be bothered. They described their state as dead
and deader."
Afterwards, some of the test cases started going to the gym and established
new businesses. And, unlike psychiatric medications, there were no
psychological side effects.
For years, Rob Matte was so depressed he couldn't get out of bed.
"I couldn't work. I couldn't physically take care of myself. I couldn't
bathe. I wouldn't eat," Matte told CTV's Avis Favaro.
After medication and shock therapy failed to work, Matte tried DBS and now
says his depression is gone.
"The magnitude of the benefits we have seen are so striking that most
patients and their families, when they see it . . . will be interested in
this surgery," said Toronto Western Hospital surgeon Dr. Andres Lozano.
Two other patients, both men, lapsed back into depression within six months.
But the researchers believe that fine-tuning the treatment could eventually
help most cases.
The researchers believe their technique works by modulating electrical
activity in the brain mood control centre.
"Our study shows that areas of the brain that are on overdrive in patients
with severe depression can be pinpointed, turned down and brought to a more
normal level of activity using electrical stimulation," explained Lozano.
"This in turn can lead to a lifting of depression in certain patients."
While DBS has been used to treat other brain disorders such as epilepsy and
Parkinson's disease, this is the first report of DBS in the subgenual region
for major depression.
The treatment is not altogether a cure, since the positive effects were
reversed when stimulation was turned off, but could then be returned when
resumed. But Dr. Lazamo says he's encouraged.
"So far, the longest follow-up is about a year-and-a-half and the results
are sustained. So patients have improved with their depression quite
significantly... It's quite a striking result in this population of
patients," he told Canada AM.
"Our next goal is more patients and also to introduce this surgery to other
centres in Canada and throughout the world to see whether, indeed, the
results are reproducible and whether we can define who should be operated,
who can benefit from this type of surgery." I heard about this. Amazing. Scary stuff though. The heart pacemaker is a proven technology that evidently fits the
requirements.
There was a bit more information in the interview with the researchers and
two of the test subjects who had benefitted from this research. If this was to work out and become an accepted medical practise, the
methodology would likely become much more refined. If this works for depression, my question is: Can anxiety and panic
disorders could have a similar type of "fix?"
This is a brand new area so...I let my imagination "fly!"
