Deep Brain Stimulators for Depression
Standard antidepressant medications work well for many patients with depression but not for everyone . Other options exist but are used much less often. Treatments like electroconvulsive therapy ( ECT )are reserved for only a few patients. Other treatments such as transcranial magnetic stimulation ( TMS ) appear to hold promise but are still in the early phases of development.
A new promising depression treatment previously used for patients with severe tremor due to neurologic disease is the implantation of a deep brain stimulator in a patients brain. Deep brain stimulators are pacemaker-like devices that use electrical pulses to give effective relief from severe tremor symptoms to Parkinson’s patients and others with tremors that interfere with their lives. There is 20 years of experience in the treatment of Parkinson’s disease using deep brain stimulators.
It appears that stimulation of the brain by these pacemaker devices may also alleviate severe depression and obsessive compulsive disorder. Specific centers in the brain must be targeted for stimulation. The stimulus is adjusted over time based on the patients response.
The mechanism by which the deep brain stimulation helps stop depression is not well understood. Scientists believe that areas of the brain that affect mood can be overactive in depressed patients. By electrically stimulating the overactive depression centers, it may be possible to reset these parts of the brain to a more normal level.The short term results of the deep brain stimulators appears to be good. The long term results are unknown at this point. Studies at major medical centers including The Cleveland Clinic, Brown University Medical Center and Massachusetts General Hospital are now underway.
Treatment with deep brain stimulation has so far been used in small studies with the most severe drug resistant type of depression. In about half of these patients, there was a 50% reduction in symptoms of depression. Other patients also experienced improvement but did not achieve as much reduction in there symptoms.
