A man who underwent brain stimulation had previously tried 20 treatments for his depression
Damien Fair et al./cc-by 4.0
Men suffering from severe depression for over 30 years have seemingly found relief through a personalized brain “pacemaker” designed to selectively stimulate various brain regions.
“He’s felt joy for the first time in years,” states Damien Fair from the University of Minnesota.
Treatment-resistant depression is often characterized by minimal improvement after trying at least two antidepressants. While procedures like electroconvulsive therapy (ECT) may provide some benefits, they don’t always yield relief. “They’re effective for all sizes. You’ll target the same brain area,” Fair explains. Yet, as every brain is unique, he often doesn’t hit the exact target needed for individual relief.
Fair and his team have now created a tailored method for a 44-year-old man, who was first hospitalized for depression at 1 PM. He had attempted 20 different treatments, including antidepressants, therapy, ECT, and more, all without lasting success. “It’s one of the most severe depression cases I’ve seen; he has attempted suicide three times,” Fair notes.
Initially, the researchers conducted a 40-minute MRI scan to delineate the boundaries of four brain activity networks linked to depression. This particular network in the man was found to be four times more active than that of individuals without depression, potentially exacerbating his symptoms, according to Fair.
The team then surgically implanted clusters of four electrodes at these defined boundaries, entering through two small openings in the skull. Just three days later, they began sending weak electrical pulses through wires attached to the electrodes, stimulating each brain network separately.
Upon stimulating the first network—default mode, related to introspection and memory—the man cried tears of joy. “I felt so much better,” Fair recalls.
Stimulation of the Action Mode and Salience Networks also led to reduced feelings of anxiety, while the team noticed enhanced focus when targeting the parietal networks involved in decision-making.
Using the man’s feedback, the team connected the electrode wires to tiny batteries placed just beneath the skin near the collarbone, allowing him to maintain these benefits outside the hospital. This setup acts like a “brain pacemaker,” as Fair describes it, stimulating various networks for a minute each day.
For six months, the man utilized an app linked to the pacemaker to alternate between different stimulation patterns crafted by the team every few days. He also documented his depression symptoms daily. The team optimized the stimulation based on this data during the first six months post-surgery.
Even seven weeks post-surgery, the man reported no suicidal thoughts. By the nine-month mark, he was in remission as per the Hamilton Depression Rating Scale. This improvement persisted for over two and a half years, apart from a brief period when his symptoms slightly recurred after contracting Covid-19.
“This is an incredible outcome,” states Mario Juruna from King’s College London. “It serves as a crucial proof of concept for patients unable to tolerate traditional depression treatments.”
Researchers have noted that compared to previous attempts at personalized brain stimulation, their method required fewer computational resources and led to shorter hospital stays.
It’s plausible that the expanded salience network of the man played a role in the treatment’s success. This is often present in depression; however, it’s premature to conclude if individuals with a lower level of salience network expansion would respond similarly, Juruena states.
To confirm the safety and effectiveness of this approach, randomized controlled trials assigning various individuals with depression to either stimulation or placebo will be necessary, according to Juruena. The team aims to conduct these trials within two years after testing the method on additional individuals, according to Fair.
If you need someone to listen, reach out: Samaritans in the UK at 116123 (Samaritans.org); US 988 Suicide & Crisis Lifeline: 988 (988lifeline.org). Visit bit.ly/suicidehelplines for resources in other countries
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Source: www.newscientist.com
