Healthy Minds - 706 - Deep Brain Stimulation Treatment Resistant Depression

Introduction

Introduction

Welcome to "Healthy Minds." I'm Dr. Jeff Borenstein. Everyone is touched by psychiatric conditions, either themselves or a loved one. Do not suffer in silence; with help, there is hope.

Today on "Healthy Minds," we discuss deep brain stimulation (DBS) with Dr. Helen Mayberg. DBS is an experimental, invasive surgical procedure that has helped a number of people with severe treatment-resistant depression.

This program is brought to you in part by the American Psychiatric Association Foundation, the Bank of America Charitable Gift Fund, and the John and Polly Sparks Foundation.

What is Deep Brain Stimulation?

Deep brain stimulation (DBS) is a surgical treatment used to treat a variety of neurological and now psychiatric disorders by delivering continuous, precise stimulation to a specific location in the brain. This process involves the implantation of a small wire in the targeted brain area, which is connected to a battery pack providing continuous stimulation to tune a malfunctioning circuit.

People often refer to DBS as being similar to a pacemaker for the brain. This technology has been used to treat movement disorders like Parkinson’s and is now being applied to psychiatric disorders including obsessive-compulsive disorder and depression.

Understanding Brain Circuits

The brain consists of billions of neurons and connections. Dr. Mayberg explains that brain regions communicate with each other and organize as circuits or networks, which are crucial when thinking about DBS. The treatment isn’t just stimulating a spot but the entire network it’s connected to, similar to an electrical grid.

The Evolution of DBS for Depression

Dr. Mayberg, a Neurologist, aimed to understand why some people recover from depression and others don’t. She discovered that some brain regions repeatedly showed abnormalities in people who didn't respond to existing treatments. With continuous stimulation and refinement of DBS, she found many patients not only improved but stayed well.

The Procedure

The DBS procedure involves advanced imaging to precisely target a brain area followed by the placement of a wire connected to a battery pack. The goal is to tune brain circuits that are malfunctioning in treatment-resistant depression.

Patient Experiences

Seeing a person who had been severely depressed without improvement from various treatments get better with DBS is incredibly rewarding. Dr. Mayberg describes how patients, who had lost all hope, eventually regained their lives back and stayed well for many years.

Future Directions

Dr. Mayberg envisions a future where non-invasive forms of brain stimulation might replace invasive DBS. Approaches like transcranial magnetic stimulation (TMS) are promising as they can also modulate brain circuits. The aim is to understand which treatment is best for each patient and ensure they receive the most beneficial care.

Message of Hope

For those with treatment-resistant depression or their loved ones, Dr. Mayberg advises never to give up. Getting another opinion and exploring various available treatment options, including experimental trials, can provide new hope.

Conclusion

With continuous research and understanding of brain circuits, treatments like DBS offer real hope for those with severe depression. Dr. Mayberg’s work highlights the importance of perseverance in seeking effective treatment.

Until next time, I'm Dr. Jeff Borenstein. Do not suffer in silence; with help, there is hope.

Keywords

• Deep Brain Stimulation (DBS)
• Treatment-Resistant Depression
• Brain Circuits
• Neurology
• Transcranial Magnetic Stimulation (TMS)
• Psychiatric Disorders
• Neural Stimulation
• Mental Health Treatment
• Patient Recovery

FAQ

What is Deep Brain Stimulation (DBS)?

Deep Brain Stimulation (DBS) is an invasive surgical treatment that delivers continuous, precise stimulation to a specific location in the brain to treat various disorders, including severe depression.

How does DBS work?

DBS involves the implantation of a small wire in the brain, connected to a battery pack. This setup provides continuous stimulation to tune malfunctioning brain circuits.

Who can benefit from DBS?

DBS is primarily used for individuals with severe, treatment-resistant depression who have not responded to other treatments such as medication, therapy, or electroconvulsive therapy (ECT).

Is DBS a permanent solution?

DBS can provide long-term improvement for many patients, with some remaining well for over 15 years. However, it remains experimental and requires continuous evaluation.

What are the future directions for depression treatment?

Research is exploring non-invasive forms of brain stimulation, like transcranial magnetic stimulation (TMS), to offer more options for modulating brain circuits without the need for surgical implants.

What should someone with treatment-resistant depression do?

Never give up hope. Seek another opinion, explore all treatment options, including experimental trials, and regularly evaluate possible underlying causes or additional factors affecting treatment efficacy.