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Deep Brain Stimulation

Shock Therapy for Depression

Sufferers of deep depression may finally have a solution to an illness that can literally debilitate living. Depression is now getting the sort of attention that cancer and AIDS have been getting for years, though it has no doubt affected just as many people over the decades. However even with this new attention, it is neither curable nor necessarily easy to live with. 

A new idea which was recently presented before the American Association for Neurological Surgeons annual scientific meeting hopes to provide help to those suffering from depression, often untouchable through normal methods.

It’s somewhat akin to a pacemaker for your heart, but this time specially modified for your brain.  This new device jolts the brain and regulates mood circuits. The hope is that this will ease deep depression.

“Depression is a physiological disorder, and basically we are regulating the abnormal signals to the brain causing the depression,” says Dr. Ali Rezai, director of the Center for Neurological Restoration at the Cleveland Clinic in Ohio.

Rezai was one of several scientists who conducted the research from Butler Hospital/Brown Medical School, Massachusetts General Hospital and Harvard Medical School.

Deep brain stimulation (DBS) is not a new technology, and has been used as a treatment for Parkinson’s disease, multiple sclerosis, essential tremor and other tremor-related illnesses. And unlike electroconvulsive therapy, DBS is much more selective, and thus doesn’t produce seizures or the same cognitive and memory side effects that electroconvulsive therapy is known for.

The process requires neurosurgeons to implant the small device in to a specific node of the cerebral cortex that is believed to be malfunctioning. From there, wires are tunneled in behind the ear and into the chest, where power sources will power the electrodes emitting the electrical impulses.

The theory is that this stimulation will block the abnormal brainwave activity, and subsequently ease obsesses ions, moods and depressive symptoms associated with these psychiatric disorders.

“This research substantiates earlier findings which indicate DBS holds promise and hope for select patients suffering from severe and treatment-resistant major depression,” Rezai said. “I feel that as we learn more about this rather new technology, efficacy will continue to improve.”

Researchers however are quick to point out that this is not a cure-all for those suffering from mild or occasional depression. This process is for those suffering from major depression, for which all other methods have failed, including psychotherapy, drug therapy and electroconvulsive therapy.

Such extreme methods are vital for treating illnesses such as major depression, considering that the suicide rate for sufferers comes in at 15%. And without playing the numbers game, this rate of suicide is comparable to heavy alcohol abusers (20%) or substance abusers (29%).

Although DBS can be associated with brain hemorrhage and a small risk of leakage of cerebrospinal fluid, “In this group of patients, we saw no major side effects,” Rezai said. Even surgeons who lean towards conservatism when it comes to advocating surgery for psychiatric disorders look on DBS kindly.

“This sort of study opens the door to applying DBS to all sorts of psychiatric conditions, even eventually Alzheimer’s disease and morbid obesity,” said Dr. Michael Schulder, spokesman for the American Association of Neurological Surgeons and president of the American Society for Stereotactic and Functional Neurosurgery. He stressed though that all studies on patients with psychiatric disorders must be treated with extra special care.

Naturally, if we are hearing about this now, any real world implications are a few years down the track (for those suffering from depression). A clinical trial is being launched this year, and other companies such as St. Jude Medical Inc. and Cyberonics Inc. will also be testing the technology.