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For many years, many people with Parkinson's disease have benefited from this possibility. to stimulate your brain with electrical impulses. Many doctors have tried to use similar techniques to change the mood of depressed people, but attempts to prove their effectiveness on a large scale have had limited effects. When deep brain stimulation is applied to small groups of patients, during the phases of the first study, the results are promising, even surprising, because they allow people who have been depressed for a long time to feel better. Indeed, according to the SINC agency Daamian Denys, a researcher at the University of Amsterdam (The Netherlands), the main problem of treatment could be its effectiveness. "Imagine that you are a father with a wife and children and you have been depressed and prostrate on the couch for 30 years, you start treatment and suddenly, one day, you go home and you are active, you are interested in everything, you go out and buy tickets for Paris for the whole family because you want to see the Louvre.The symptoms disappear and people change a lot in a very short time.For the family, work and the environment in general, this change is so brutal that it can even generate a sense of threat, "he said. When the treatment is undergoing extensive clinical trials, however, it is still difficult to demonstrate its effectiveness.
Today, a team of researchers from the University of California at San Francisco (UCSF) in the United States still show promising results against depression in a small group of patients treated with electrical stimuli. In an article published in the journal Current Biology they explain how they stimulated the lateral orbitofrontal cortex, a region located above the orbits and related to the treatment of emotions and reward. . As the authors explain, the electrical impulses improved the mood of the patients and produced an activity similar to that observed in a person of good humor. In a certain way, the stimulation has allowed the circuits related to the mood to function properly.
Deep brain stimulation is invasive and only applies to people who do not respond to other treatments for depression
. mood of depressed patients, the most appropriate areas for each type of patient were sought after, but, according to Kristin Sellers, researcher at UCSF and co-author of the study, "our understanding Depression is not enough to achieve this kind of customization ", although hopefully this will be the case. For now, "there are several stimulation targets that could help alleviate symptoms." "It can be like entering a highway, there are several ramps to get to the road you want to reach," he says.
The study of the effects of electrical stimulation has significant limitations. One side, to implant the electrodes with which to apply it, it is necessary that patients undergo surgery, an invasive procedure leaving this option only to depressed people who do not respond to more conventional treatments such as drugs In the study published today, to explore the orbitofrontal cortex as a target for electrical stimulation, the researchers took advantage of a group of 25 people with epilepsy already implanted with electrodes to to find the source of their schizophrenia outbreaks, suffered from depression. "One question we must answer is whether the stimula This area also relieves the symptoms of depressed people but without epilepsy. "In addition, they should suggest trials in which patients are followed for a long time and not only observe relief for a week or two, as has been the case. done with this study.
While brain areas are better understood and ideal for stimulation, devices are being developed to allow its application without surgery. The discovery of more accessible regions will also facilitate the implementation of this less invasive technology.
In Spain, there are few centers where surgery is performed to place electrodes and treat depression with electrical impulses. Marta Navas, neurosurgeon at the Princesa Hospital in Madrid, explains that with her partner, Cristina Torres, they operated on three people. Two of them had a surprising recovery and a third reacted well to the surgery, but is still in the follow-up period. "These patients require significant vigilance, often require adjustments and surgeons must cooperate with psychiatrists to perform them," Navas said. "One of those patients, for example, started to feel bad and that was because he had exhausted the battery of the device," he says. Although he believes that this type of treatment is effective, Navas emphasizes a reluctance on the part of psychiatrists to leave patients in their hands. "Patients must be well selected and meet the appropriate criteria, but therapy is safe," Navas concludes.
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