October 20, 2021

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Implanting a “pacemaker” in brain to successfully cure major depression

Implanting a “pacemaker” in the brain to successfully cure major depression through electrical stimulation



 

Implanting a “pacemaker” in the brain to successfully cure major depression through electrical stimulation. 

The first case in the world! Implanting a “pacemaker” in the brain to successfully cure major depression through electrical stimulation.

 

In modern society, as the pace of life is getting faster and faster, work pressure is increasing, but entertainment time is getting less and less.

These complex social factors cause anxiety and negative emotions to spread like weeds, and the psychology of depression Diseases are also becoming more common in the general population.

 

Depression, with significant and lasting depression as the main clinical feature, is the main type of mood disorder. Clinically, it can be seen that depression, depression, inferiority and depression, and pessimistic life-weariness, and some patients even have suicide attempts or behaviors.

More importantly, there is currently no clinically effective treatment for depression, as the popular saying: “Sometimes cure, often help, always comfort.”

 

Recently, the Katherine Scangos team at the University of California, San Francisco published a research paper titled: Closed-loop neuromodulation in an individual with treatment-resistant depression in the top international medical journal Nature Medicine.

 

The research is based on a specific brain circuit related to depression, using a device equivalent to a “brain pacemaker” to reset it, and successfully treated a patient who suffered from severe depression and failed multiple treatments. This is an important milestone in the application of advances in neuroscience to the treatment of mental illnesses over the years.

 

Implanting a "pacemaker" in the brain to successfully cure major depression through electrical stimulation

 

Deep brain stimulation (DBS) is a promising treatment for neuropsychiatric diseases such as severe depression.

However, previous clinical trials have shown that the efficacy of traditional DBS in the treatment of depression is very limited, partly because most devices can only provide continuous electrical stimulation, and usually only in one area of ​​the brain.

However, more and more studies have shown that depression may involve different brain regions and vary from person to person.

 

On January 18 this year, the Katherine Scangos team published a paper in the journal Nature Medicine, implanting multiple intracranial electrodes in patients with severe depression, and systematically assessed the acute response to focal electrical neuromodulation.

The results of the experiment found complex and unique emotional responses, which are effective, reproducible, and related to the background and state.

These research results provide a proof of concept for the treatment of depression and other neurological diseases through intracranial electrical stimulation.

 

Implanting a "pacemaker" in the brain to successfully cure major depression through electrical stimulation

 

In 2013, then US President Barack Obama announced the launch of a large-scale “BRAIN Initiative.” Through this initiative, Dr. Edward Chang, a neurosurgeon at the University of California, San Francisco, and his colleagues conducted research to understand the depression and anxiety of patients undergoing epilepsy surgery.

 

The research team discovered patterns of brain electrical activity associated with emotional states and developed a new treatment method—the first use of multi-day intracranial electrophysiology and focused electrical stimulation to identify personalized symptom-specific biomarkers and stimuli The location of treatment to improve symptoms.

 

Implanting a "pacemaker" in the brain to successfully cure major depression through electrical stimulationNeurological biomarkers of depression and neural circuits in the brain

 

 

Then, the researchers implanted a chronic deep brain sensing and stimulation device in the brain of a severely depressed patient, and implemented a biomarker-driven closed-loop therapy on the patient. This closed-loop therapy allows the patient’s depressive symptoms to be quickly and continuously improved.

 

In order to make the treatment more personalized, the researchers placed one electrode lead in the “brain pacemaker” in the brain area where they found the biomarker, and the other lead in the depressive neural circuit area of ​​the brain.

When the “brain pacemaker” detects a specific biomarker, the device sends a signal to another wire, and then delivers a tiny dose of electric current (1mA) within 6 seconds to change the patient’s nerve activity.

This creates a unique on-demand instant therapy for the patient’s brain and depression neural circuits.

 

Implanting a "pacemaker" in the brain to successfully cure major depression through electrical stimulation“Brain pacemaker”

 

 

More importantly, compared with the 4-8 week delay of the standard treatment model, this customized method almost immediately relieves the patient’s depressive symptoms, and it has lasted for 15 months. For long-term and difficult-to-treat depression patients, this result may be revolutionary!

Dr. Katherine Scangos, the first author and corresponding author of this study, said: “The effectiveness of this therapy shows that not only did we identify the correct brain circuits and biomarkers, but we were able to use implants at a completely different later stage of the trial. Copy it into the device. This success itself is an incredible advancement in our knowledge of the brain functions that make up mental illness.”

 

“Brain pacemaker” significantly improved the patient’s depressive symptoms

 

 

Although this method looks promising, the research team reminded that this is only the first patient in the first trial, and the safety and effectiveness of this treatment method need to be further confirmed in the follow-up. At present, the research team has recruited two other patients to participate in the trial and hopes to add another 9 patients.

 

Dr. Katherine Scangos said: “We still have a lot of work to do. We need to study how these depression neural circuits change between different patients, and repeat this work many times. We need to know that as treatment continues, individual Will biomarkers or brain circuits change over time.”

 

In any case, although it will take a long time for the FDA to approve this therapy, this study points out a new way to treat severe depression. This also reminds us that understanding the brain circuits behind depression may guide non-invasive treatments that can regulate these circuits in the future, and humans may be able to completely cure depression.

 

 

 

 

Paper link:
https://www.nature.com/articles/s41591-021-01480-w
https://www.nature.com/articles/s41591-020-01175-8

Implanting a “pacemaker” in the brain to successfully cure major depression through electrical stimulation

(source:internet, reference only)


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