An experimental brain implant has successfully been used to treat severe depression in a woman. This is a remarkable breakthrough that gives hope for those suffering from serious mental illness.
The device detects depression-related brain activity and interrupts it using small electrical stimulation pulses deep within the brain.
Sarah, 36, stated that the therapy had allowed her to live a happy life and she was able to laugh for the first times in five years.
The therapy was only tested on one patient, and it would not be applicable to patients with serious illness. However, the results are hugely significant. This is the first time that brain activity that causes mental illness symptoms can be detected reliably. It also reveals that brain circuits can be re-energized, even in patients who have been sick for many years.
Katherine Scangos, assistant professor of clinical psychiatry (UCSF), was the one who led the research. This is an amazing breakthrough in our understanding of brain function and mental illness.
Professor Rupert McShane of Oxford University was a consultant psychiatrist who was not part of the trial. He said that this is a remarkable demonstration which shows how biology can be used to examine the sudden slumps into despair.
About 2.7 million people in Britain suffer from depression. Between 10% and 30% do not respond to at minimum two treatments.
Deep brain stimulation (DBS), has been used to treat thousands of epilepsy and Parkinson's patients over the past 20 years. Several trials to treat depression ended in failure. The brain doesn't appear to have one depression area. There can be many interconnected areas, and they can vary between people.
Prof Edward Chang, a neurosurgeon who treated Sarah, stated that we are beginning to recognize the complexity of how mood is controlled in the brain network.
The latest breakthrough was possible thanks to a personalized, meticulous approach. A temporary brain implant was used to record a wide range activity in a phase that lasted one week. Sarah also regularly recorded her moods on a tablet. Machine learning algorithms were used to detect a pattern of activity in Sarah's amygdala.
The scientists discovered a brain area that was closely linked to the ventralstriatum through trial and error. A small amount of electricity seemed to have a profound and immediate effect.
Sarah said that I experienced the most joyous sensation when I received stimulation for the first time. My depression disappeared for a second. I laughed out loud. This was the first time in five years that I have spontaneously laughed or smiled.
A second round of minimally invasive surgery was performed to implant a permanent device with a small battery unit in her skull to detect depression signature activity and deliver stimulation to the ventralstriatum.
It happens approximately 300 times per day. This is equivalent to 30 minutes of stimulation. Sarah stated that the electrical pulse does not produce any sensations, other than a subtle sense of alertness or positivity.
Scangos stated that the idea of treating depression symptoms as they occur is a new way to address the most severe cases. She hopes that the work will help to end the stigma associated with depression's black box nature.
Sarah described her life before the treatment, in which she was unable to move, had no opinions and saw only the ugly things in the world. She was exhausted by all options after five years of pain. She was convinced that her depression was not due to moral failings, but brain biology.
It costs approximately $35,000 (26,000). The NeuroPace RNS system is an adaption of the NeuroPace RNS system, which is used to treat epilepsy. Two more patients have been enrolled by the UCSF team. The team hopes to enroll nine more to test whether the technique is more broadly applicable.
Professor Eileen Joyce of Neuropsychiatry, University College London, is leading a trial that uses deep brain stimulation to treat OCD. She said: "The results are real and significant. It's an amazing piece of clinical translational neuroscience. I'm not certain if anyone else is doing this at the moment, but I am sure they will in the future.
McShane stated that although the method is not widely used or applied immediately, it would make sense for a medical student to consider psychiatry if they were looking at which field would show interesting developments in their working lives. These findings were published in Nature Medicine.
