Brain Implant Relieves Severe Depression in Patient in US Landmark Study

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US researchers have successfully alleviated a patient’s severe, long-term depression with an electronic implant that acts as a neural pacemaker, resetting brain circuits associated with negative feelings.

The team at the University of California at San Francisco (UCSF) said the study was “a historic success” in the scientific effort to treat psychiatric disorders with carefully targeted neural electronics. The study is published in the journal Nature Medicine.

“We have developed a precision medicine approach that has successfully managed our patient’s treatment-resistant depression by identifying and modulating the circuit in her brain that is uniquely associated with her symptoms,” said Andrew Krystal, professor of psychiatry. at UCSF.

In a press conference call ahead of the study’s publication, the 36-year-old patient, who simply asked to be called Sarah, said the implant had transformed her life after five years of severe depression that would not respond to no combination of drugs or electroconvulsive therapy. . “I felt tortured by suicidal thoughts every day,” she said. “I was on the phone.

Almost immediately after being inserted deep into her brain, the device brought relief, which has so far lasted for a year. When it detects neural activity associated with irrational thoughts, which previously triggered depressive obsessions, its electrodes deliver a short corrective electrical pulse and “poof… the cycle stops,” as Sarah put it.

Deep Brain Stimulation (DBS) has recently become a routine treatment for epilepsy and Parkinson’s disease, but has had limited success in depression, which affects 280 million people worldwide, according to the World Organization. health. Up to 30 percent of depressed patients do not respond well to existing treatments.

The problem with the application of neuroelectronics to depression was that scientists knew relatively little about the brain circuits associated with the disease. The key finding of the UCSF team was a “biomarker” indicating the onset of depressive symptoms, a specific pattern of neuronal activity in the part of the brain called the amygdala that processes responses to threats.

The DBS device used in the study was adapted from a device used to treat epilepsy. When it detects the biomarker in the amygdala, it sends tiny electrical impulses to another area, the ventral striatum, which is part of the brain’s reward and pleasure system. This immediately lifts the unwanted mood symptoms.

Sameer Sheth, a neurosurgeon at Baylor College of Medicine in Houston who was not involved in the UCSF research, is leading another trial of custom implants to treat depression and is set to report positive results. He said both projects indicated a trend in research towards developing “a more individualized approach to psychiatric treatment,” based on the stimulation of specific brain circuits.

While the approach is promising, Sarah was the first patient in the first published trial, warned Katherine Scangos, assistant professor of psychiatry at UCSF. Scangos recruited two more people with severe depression to participate in the research and is targeting 12 patients in total.

“We have to look at how these circuits vary from patient to patient and repeat this work several times,” she said, “and we have to see if an individual’s biomarker or brain circuit changes over time. time as processing continues. “

Securing an implant under the skull with electrodes extending deep into the brain is an expensive, invasive, and potentially risky procedure. Once the details of the brain circuits underlying depression are better understood, “we hope to find non-invasive biomarkers that can be used with non-invasive treatments,” Scangos said.

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