Brain implant relieves patient’s severe depression in “landmark” US study

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

The team from the University of California, San Francisco (UCSF) said the study was “a landmark breakthrough” in the scientific effort to treat psychiatric disorders through carefully targeted neural electronics. This study is published in the journal Nature Medicine.

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“We have developed a precision medicine approach that has successfully managed our patient’s treatment-resistant depression by identifying and modifying circuits in their brain,” said Andrew Crystal, a UCSF professor of psychiatry.

In a press teleconference prior to the study’s publication, the 36-year-old patient, who asked just to be called Sarah, said the transplant had changed her life after five years of intense depression that responded to any drug combination or electroconvulsive therapy. will not give . “I used to feel tormented by suicidal thoughts every day,” she said. “I was at the end of the line.”

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

According to the World Health Organization, deep brain stimulation (DBS) has recently become a routine treatment for epilepsy and Parkinson’s disease, but has had limited success against depression, which affects 280 million people globally. At least 30 percent of depressed patients do not respond well to existing treatments.

The problem with applying neuro-electronics to depression was that scientists knew relatively little about the brain circuits associated with the condition. The UCSF team’s key discovery was a “biomarker” indicating the onset of depressive symptoms, a specific pattern of neural activity in the part of the brain called the amygdala that deals with responses to threats.

The DBS device used in the study was adapted from a device used to treat epilepsy. When it detects a biomarker in the amygdala, it sends short electrical pulses to another region, the ventral striatum, which is part of the brain’s reward and pleasure system. It removes unwanted mood symptoms instantly.

Sameer Sheth, a neurosurgeon at Baylor College of Medicine in Houston who was not involved in the UCSF research, is conducting another trial of personalized implants to treat depression and is about to publish positive results. He said the two projects indicated a trend in research toward developing “a more personalized approach to psychiatric treatment” based on stimulating specific brain circuits.

Although the outlook was promising, Sarah was the first patient in a previously published trial, cautioned Katherine Skangos, assistant professor of psychiatry at UCSF. Scangos enrolled two more people with severe depression to participate in the research and aims to cover 12 patients in total.

“We need to look at how these circuits differ across patients and replicate this work multiple times,” she said, “and we need to see if a person’s biomarkers or brain circuits over time as treatment continues.” Varies with or not.”

Attaching an implant under the skull with electrodes propelled 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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