A Promising Therapy for Hard-To-Treat Depression: Deep Brain Stimulation



According to a study, depression may be treated by deep brain stimulation of the parts of the brain connected to motivation and rewards.

Deep brain stimulation (DBS) to the superolateral branch of the medial forebrain bundle (MFB), which is connected to motivation and reward, revealed metabolic changes in the brain over a 12-month period following DBS implantation, according to researchers at the University of Texas Health Science Center at Houston. This makes it an effective prospective therapy for depression that is resistant to treatment.

The results of the study, which involved 10 patients, were released in the Molecular Psychiatry journal.

The first author, Christopher Conner, MD, remarked, "This is something that people have been trying to achieve for a long time, but we have not always been very successful with using DBS for mental diseases. Conner served as a neurosurgery resident in the McGovern Medical School at UTHealth Houston's Vivian L. Smith Department of Neurosurgery. However, this PET study demonstrates that we are starting to affect how the brain organizes itself and begins to process information and data, as well as how it functions over the long term. Conner is a fellow at the University of Toronto right now.

DBS has being studied as a potential therapy for persons with treatment-resistant depression. It has long been used to treat people with movement disorders, including as Parkinson's disease, tremors, and dystonia. In DBS, electrodes are inserted into particular brain regions, where they generate electrical impulses that alter brain function.

It has proven challenging to pinpoint the precise region of the brain that needs to be treated for depression over the long term.

We focused on a group of fibers that exit this tiny region of the brainstem and proceed to several other regions of the brain, according to Conner. "The PET scans revealed that the downstream effects of this small target area are quite diffuse. Because depression is linked to many different areas of the brain, there isn't just one consequence. The entire brain needs to be altered, and we were able to do that by focusing on just one small target.

Each of the 10 study participants underwent a baseline PET scan before the DBS treatment. After six and twelve months, further PET scans were performed to assess any treatment-related changes. Scan results for eight out of 10 patients revealed a reaction.

A responder to the treatment, according to co-author Joo de Quevedo, MD, PhD, professor in the Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, "means that your depression potentially lowers at least 50%; you're feeling substantially better." "So, reducing our symptoms by half is a lot for patients with severe chronic treatment-resistant depression. It's the distinction between being unable to accomplish something and being able to do it. Our patients said that after receiving treatment, their depression improved, which was consistent with the improvements in the PET images. De Quevedo also oversees the Center of Excellence on Mood Disorders' Translational Psychiatry Program and the Treatment-Resistant Depression Program.

By UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON  


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