The researchers caution that the findings have so far only come from one patient, and more work is needed.
Researchers at the University of California San Francisco announced Monday that a woman suffering from severe depression saw near-immediate relief when she was treated with a surgically implanted device to stimulate neural circuits.
The so-called “deep brain stimulation” (DBS) device was touted as the equivalent of a pacemaker for the brain, according to a university release issued Monday, with a report good On the proof-of-principle trial published in the journal Nature Medicine.
“This study points to a new paradigm that is desperately needed in psychiatry,” said Andrew Crystal, PhD, professor of psychiatry and member of UCSF Weill Institute for Neurosciences, said in a statement. “We developed a precision-medicine approach that successfully managed our patient’s treatment-resistant depression by identifying and modifying circuits in his brain that are uniquely linked to his symptoms.”
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The researchers said that preclinical trials on DBS indicated only limited success in treating depression because most devices provide continuous electrical stimulation, usually to one area of the brain, while depression is different for different people. Can affect different areas. This time, the initial findings were considered successful because the researchers discovered a neural biomarker, described as “a specific pattern of brain activity that indicates the onset of symptoms”, and then detected that pattern. Optimized the device to respond.
The team of researchers cautioned that the findings come from the first patient in the trial, and more work is needed. Nevertheless, personalized therapy involved placing an electrode lead in the patient’s brain region detected with biomarkers to monitor activity, and another lead was placed in the patient’s depression circuit, that when treated, So the patient’s mood symptoms are best relieved.
When the first lead “detected” the biomarker, the device signaled the second lead to deliver a small (1mA) dose of electricity for 6 seconds, which changed neural activity, release reads. Researchers assessed the approach in June under the FDA Investigative Device Waiver, and according to the university, FDA approval for the treatment is “still down the road.”
However, the standard treatment model reports near-immediate benefits to the patient as opposed to a delay of 4-8 weeks and the reduction of symptoms for more than 15 months since the device was implanted, according to the university.
“I was at the end of the line,” said patient Sarah, who requested to be identified by her first name. “I was seriously depressed. I couldn’t see myself going on if I could only do that, if I couldn’t move on. It was not a life worth living.”
The findings are said to have resulted from former President Obama’s BRAIN (Brain Research through Advancing Innovative Neurotechnology) initiative in 2014, followed by UCSF neurosurgeon Dr. edward chang and others on depression and anxiety in patients treated surgically for epilepsy, found that new areas of the brain may be stimulated to reduce depressed mood, among other results.
“The effectiveness of this therapy showed that not only did we identify the correct brain circuit and biomarker, but we were also able to replicate this in a completely different, later phase of trial using the implanted device,” said first author Katherine Scangos. said. Statement. “This breakthrough in itself is an incredible advance in our knowledge of brain function at the base of mental illness.”
The treated patient, Sarah, said the combination of therapy and self-care has so far stopped a cycle of irrational thoughts and emotional triggers.
Further research efforts will examine individual circuits in patients and whether biomarkers or brain circuits change over time during the treatment period, Scangos said.