Promising treatment for hard-to-treat depression: deep brain stimulation

Brain pain and depression

The National Institutes of Health estimates that in 2020, approximately 21.0 million individuals had at least one major depressive episode in the United States.

A study has found that deep brain stimulation of areas of the brain associated with reward and motivation can be used as a potential treatment for depression.

According to researchers at University of Texas The Houston Health Science Center, Deep brain stimulation (DBS) of the supralateral branch of the medial forebrain (MFB) bundle, associated with stimulation and reward, revealed metabolic changes in the brain during a 12-month period after DBS implantation. This makes it a powerful potential treatment for treatment-resistant depression.

The results of the study, which included 10 patients, were published in the journal Molecular Psychiatry.

“This is something people have been trying to do for a long time, but we haven’t always had success with DBS for psychiatry,” said first author Christopher Conner, MD. Conner is a former resident neurosurgeon in the Vivien L. Smith Department of Neurosurgery at McGovern Medical School in UTHealth Houston. “But the PET study shows that we are changing how the brain works in the long term, and we are beginning to change the way the brain starts to organize itself and start processing information and data.” Conner is currently a fellow at the University of Toronto.

Deep brain stimulation has long been used to treat people with movement disorders including Parkinson’s disease, tremors, and dystonia, and has also been validated as a potential treatment for those with treatment-resistant depression. Deep brain stimulation involves implanting electrodes into specific areas of the brain, where they produce electrical impulses that alter brain activity.

However, deciding which brain region to target for long-term treatment of depression has been challenging.

“We targeted a bundle of fibers that leave this small area in the brainstem to travel to other areas throughout the brain,” Conner said. “The PET scans indicated that this small target area has very diffuse effects downstream. It is not a single effect because there is not a single area of ​​the brain associated with depression. The whole brain needs to be changed and through this small target, that is what we were able to than to do.”

Prior to the DBS procedure, the researchers performed a baseline PET scan on each of the 10 study participants. Additional PET scans were performed six and twelve months later to assess treatment-related changes. Eight out of ten examinations of patients showed a response.

“Responsive to treatment means your depression may decrease by at least 50%,” said co-author João de Quevedo, MD, PhD, professor in Louis A. Faillace, MD, division of psychiatry and behavioral sciences at McGovern School of Medicine, “You feel so much better.” So, for patients with treatment-resistant severe chronic depression, halving symptoms is a big deal. It’s the difference between being disabled and being able to do something. Combined with changes in the PET image, I report Our patients reported that their depression decreased after treatment.” De Quevedo also serves as director of the Transitional Psychiatry Program and the Treatment-Resistant Depression Program, part of the Mood Disorders Center of Excellence.

Reference: “Brain metabolic changes and clinical response to the supralateral forebrain bundle to deep brain stimulation for treatment-resistant depression” by Christopher R. Conner, Joao Quevedo, Jair C. Soares and Albert J. Finoy, August 19, 2022 Molecular Psychiatry.
DOI: 10.1038 / s41380-022-01726-0

Leave a Reply

Your email address will not be published.