Brain electrodes fix depression long term

January 5, 2012 | Source: Nature News

Deep depression that fails to respond to any other form of therapy can be moderated or reversed by deep brain stimulation (DBS) of areas deep inside the brain. Now the first placebo-controlled study of this procedure shows that these responses can be maintained in the long term.

Neurologist Helen Mayberg at Emory University in Atlanta, Georgia, followed ten patients with major depressive disorder and seven with bipolar disorder, or manic depression, after an electrode device was implanted in the subcallosal cingulate white matter of their brains and the area continuously stimulated. All but one of twelve patients who reached the two-year point in the study had completely shed their depression or had only mild symptoms.

DBS is hardly a quick fix for depression though. Not only does it involve invasive brain surgery, but recovery is usually slow. “In our study we found that many patients didn’t get well at all in the first months — but then they started to respond after a year or more of stimulation,” says Mayberg. It’s also not a cure, she notes, as patients quickly reverted to full-blown depression if stimulation of their electrodes was discontinued.

Placebo-controlled phase-3 clinical trials involving hundreds of patients are being carried out at multiple centers in North America and Europe by two electrode manufacturers, but those results won’t come out for several years

Ref.: Holtzheimer, P. E. et al., Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Unipolar and Bipolar Depression, Arch. Gen. Psychiatry, 2012 [DOI: 10.1001/archgenpsychiatry.2011.1456]