Brain Stimulation May Ease Depression
Technique has shown success for Parkinson's and chronic pain
(HealthDay News) -- A treatment that's more commonly used for Parkinson's disease might offer new hope to those who have severe, treatment-resistant depression.
Called deep brain stimulation, it's been shown to reduce symptoms in about half of the people treated.
"This is a new therapy for patients with severe, intractable depression," Dr. Ali Rezai, director of the Center for Neurological Restoration at the Cleveland Clinic in Ohio , told HealthDay . "There's a lot of promise for this approach."
Rezai, who led a study on use of the therapy among people with depression, presented the findings at a meeting of the American Association of Neurological Surgeons.
Deep brain stimulation works in a manner similar to a cardiac pacemaker. Much like a pacemaker helps people with heart rhythm problems maintain a regular heartbeat, deep brain stimulation helps people with brain problems maintain more normal function.
Signals are sent to areas of the brain that are believed to be malfunctioning. An electrode is implanted in the brain through a small opening in the skull, and another device, called a neurostimulator, is implanted under the skin, often near the collarbone, according to the American Association of Neurological Surgeons.
Once those devices are in place, the electrode emits electrical pulses that block the wrong signals from getting through.
The technique has been used for 20 years in the treatment of Parkinson's, according to Rezai. The surgeons' group says it's also been used for that long to treat chronic pain.
"This is not for everyday depression, but for those who have failed everything else, hope is on the way," Dr. Kathryn Holloway, an associate professor of neurosurgery at the Virginia Commonwealth University Medical Center in Richmond , told HealthDay .
Severe depression occurs in 10 to 20 percent of those who are depressed, Rezai said. The suicide rate in this group may be as high as one out of six, according to background information in the study. But many who are severely depressed don't respond to standard treatments, such as antidepressants, and they may also be resistant to electroconvulsive therapy.
Rezai and his colleagues tested deep brain stimulation on 15 people with severe depression. All had been depressed for more than five years and had not found relief with any other treatment.
The researchers found that, after six months, nearly half the participants reported at least a 50 percent reduction in their depressive symptoms. After a year, the number had increased slightly.
The technique was well-tolerated, the study reported, and all of the participants said they would undergo the treatment again. One person had a brief seizure during the study.
Deep brain stimulation, though, is not the only new depression treatment out there. Others that have shown promise include vagal nerve stimulation and transcranial magnetic stimulation.
"There are new treatments being developed that are having success where no medication has," Holloway said.
On the Web
To learn more about deep brain stimulation, visit the University of Pittsburgh
HealthDay News ; Ali Rezai, M.D., chairman in neurology and director, Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio; Kathryn Holloway, M.D., associate professor, Department of Neurosurgery, Virginia Commonwealth University Medical Center, Richmond, Va.; April 29, 2008, presentation, American Association of Neurological Surgeons annual meeting, Chicago; American Association of Neurological Surgeons (www.neurosurgerytoday.org)
April 30, 2009
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