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

Researchers in the United States have found a way to relieve severe depression and long-term anxiety using an electronic implant. This acts as a neural pacemaker and resets brain circuits that are associated with negative emotions.
University of California, San Francisco (UCSF), said that the study was a major breakthrough in the scientific effort of treating psychiatric disorders using carefully targeted neural electronic treatments. The Nature Medicine journal published the study.

Andrew Krystal, UCSF professor in psychiatry, stated that we have developed a precision medicine method that has been successful in managing patients with treatment-resistant depression. This involves identifying and modulating the brain circuit that is uniquely associated with their symptoms.

The patient, 36, spoke out at a press conference ahead of publication of the study. She asked to be simply called Sarah. After five years of severe depression, she said that the implant had changed her life. She said that she felt suicidal thoughts and tortured every day. I was at the very end of the line.

The device gave relief almost immediately after it was inserted into her brain. This has so far been for one year. It detects abnormal neural activity that could trigger depressive obsessions. The electrodes emit a brief, corrective electric pulse.

Deep brain stimulation (DBS), which has been routinely used to treat epilepsy and Parkinson's disease, has not had much success in treating depression. According to the World Health Organization, there are 280 million people worldwide who suffer from this condition. 30% of patients with depression do not respond to the existing treatments.

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Neuro-electronics was not able to treat depression because scientists didn't know much about the brain circuits involved. The UCSF team's key discovery was a biomarker that indicated the onset depressive symptoms. It was a pattern of neural activity in the brain part called the amygdala, which deals with responding to threats.

The DBS device that was used in this study was taken from an epilepsy treatment device. It sends tiny electrical pulses to the ventralstriatum which is part the brain's reward- and pleasure system, when it detects the biomarker within the amygdala. This instantly relieves any unwelcome mood symptoms.

Sameer Sheth is a Baylor College of Medicine neurosurgeon in Houston, who wasn't involved in the UCSF research. He is currently conducting another trial of personalized implant to treat depression, and is set to publish positive results. He stated that the two projects showed a trend toward personalized psychiatric treatment, which is based on stimulating specific brain pathways.

UCSF assistant professor in psychiatry Katherine Scangos warned that although the approach was promising, Sarah was not the first patient in the published trial. Scangos has now enrolled two additional people suffering from severe depression in the research, and Scangos hopes to enroll 12 patients.

We must examine how these circuits differ across patients, and then repeat this work multiple times. Additionally, we must see if a patient's biomarker or braincircuit changes as treatment progresses.

It is risky, expensive and risky to attach an implant under your skull with electrodes that reach deep into the brain. Scangos stated that once we have a better understanding of depression's brain circuits, we will be able to identify non-invasive biomarkers which can be used in non-invasive treatments.

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