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For many years, many patients with Parkinson's have benefited from the opportunity to stimulate their 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, sometimes 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 that you have been depressed and prostrate on the couch for 30 years.You start treatment and one day you come 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. However, when the treatment is tested in large-scale trials, the difficulties in demonstrating its effectiveness remain significant.
Today, a team of researchers from the University of California at San Francisco (UCSF) in the United States, once again shows promising results against depression in a small group of patients treated with stimuli electric. In an article published in the magazine Current biology, explain how they stimulated the lateral orbitofrontal cortex, a region located in 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 in a good mood. 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
To improve the mood of depressed patients, we searched for the most appropriate regions for each type of patient, but according to Kristin Sellers, UCSF researcher and co-author of the study, "our understanding of depression" is not enough "even to get this kind of customization", even if it is hoped that this will be the case.For the moment, "there are several stimulation targets that could help mitigate the symptoms." "This can be like entering a highway. Several ramps can take you to the road you want to reach, "he says.
The study of the effects of electrical stimulation presents important limitations. On 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 depressive people who do not respond to treatments more conventional ones such as drugs. In the study published today, to explore the orbitofrontal cortex as a target of electrical stimulation, the researchers took advantage of a group of 25 people with epilepsy already implanted with electrodes to find the source of their epidemics and schizophrenia, suffered from depression. "One question we must answer is whether stimulation of 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 was done with this study.
Although the areas of the brain are better understood and ideal for stimulation, devices for applying it without surgery are under development. Finding more accessible regions will also facilitate the implementation of this less invasive technology.
In Spain, there are few centers in which 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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