According to the study's principal investigator, stimulation of the nucleus accumbens may have changed the reward circuitry in the brain so that patients with alcohol use disorder feel less desire to drink.
A bigger trial is being planned to confirm the findings. He wants to find brain signatures associated with alcohol cravings so that stimulation can only be needed at certain times.
Many mental illnesses may be able to be treated with the therapy. In the September edition of the Journal of Neurology, Neurosurgery, and Psychiatry, Sheth analyzed 34 studies of the treatment of obsessive-compulsive disorder with deep brain stimulation. He found that it was effective for 66 percent of the patients.
There arechallenges to scaling the therapy. Anoremia and bulimics are hard to reproduce in mice. It's hard to move forward with human research. Regulatory authorities want to make sure the technique is safe before they approve larger human trials. Halpern says that it's important to appreciate that this started with planned mouse studies. We went to do surgery in the brain.
The trials cost a lot of money and require a lot of surgery. There can be infections at the site of the implant. Changing moods can be caused by a high Frequency of Stimulation. The Toronto trial patient became more upset after getting the brain implants. The patient's mood improved once researchers reduced the voltages. Smaller studies and lack of a placebo group make it hard to draw conclusions about effectiveness.
It can be difficult to justify a long trial if patients don't seem to be getting better. Two high-profile trials for depression failed to improve. The response rates were measured after just 16 weeks. St. Jude Medical stopped the trial early after an interim analysis showed there was no benefit compared to a sham device.
The decision to stop the trial early was a mistake according to Helen Mayberg, who was a consultant on the St. Jude study. She found that stimulating the subcallosal cingulate could relieve depression. In patients with severe depression, the region plays a role in appetite, self-esteem, sleep, and the processing of sadness. Many of the trial's patients who didn't initially respond to the therapy eventually showed improvement.
The placement of the device affects how well the therapy works. One of her patients didn't improve after six months of stimulation. The electrodes weren't inserted deep enough. The person's symptoms began to improve when it was moved to the right spot. Mayberg believes that location explains most of the variation in outcomes.
Abbott is getting ready for a new trial. The FDA gave breakthrough device designation to Abbott's system as a treatment for depression.
There are still questions about which patients will benefit from the procedure. Mayberg and her team have gathered brain recordings from severely depressed patients and believe they have a signature that indicates who will respond to therapy. Researchers are still trying to find out more about other mental illnesses. George says that there is simultaneously an amazing promise and an unfulfilled potential.
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