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Depression Community
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Promising breakthrough new treatment! Read this article!
by April2, May 27, 2008 09:39AM
This was in my paper today! Check this out:
"It's a new frontier for psychiatric illness: Brain pacemakers that promise to act as anti-depressants by changing how patients' nerve circuitry fires.
Scientists already know the power of these devices to block the tremors of Parkinson's disease and related illnesses; more than 40,000 such patients worldwide have the implants.
But psychiatric illnesses are much more complex and the new experiments with so-called deep brain stimulation, or DBS, are in thier infancy. Only a few dozens patients with severe depression or obsessive-compulsive disorder so far have been treated in closely monitored studies.
Still, the early results are promising. Dramatic video shows one patient visibly brightening as doctors turn on her brain pacemaker and she says in surprise: "I'm starting to smile." And new reports this month show that some worst-case patients -- whose depression wasn't relieved by medication, psychotherapy, even controversial shock treatment -- are finding lasting relief.
Six of 17 severly depressed patients were in remission a year after undergoing DBS and four more markedly improved, and more than half of 26 obsessive-compulsive patients showed substantial improvement over three years, say studies from a team at the Cleveland Clinic, Brown University, and Belgium's University of Leuven.
"Not all patients get better, but when patients respond, it's significant," says Dr. Helen Mayberg of Emory University, who has implanted about 50 depression patients. Her first remains in remission after five years; she estimates that four of every six show enough improvement to be classified "responders".
"We're rewiring the brain in many ways", says Dr. Ali Rezai, chief of the Cleveland Clinic's Center for Neurologic Restoration.
There's a need for innovative therapies. Up to 20 percent of depression patients and 10 percent of those with obesessive-compulsive disorder are treatment-resistant -- several million people in the U.S. alone.
The rationale behind DBS is credible, says Dr. Wayne Goodman of the National Institute for Mental Health: Surgery sometimes helps worst-case patients by destroying misfiring patches of brain tissue. The electrodes are placed into similar spots, but don't destroy tissue -- the electrical sinals can be adjusted and turned off.
But it's not yet ready for prime-time, Goodman cautions. He worries that because the electrodes already are widely available, centers without proper training will start offering the $40,000 implant surgeries to psychiatric patients beforescience prove if they're really valuable.
"It is an invasive, experimental procedure," he warns, with risks including bleeding in the brain and infections. He calls DBS "the last resort for stringently selected patients."
Earlier this month, federal health officials and the Cleveland Clinic brought together the field's leading researchers to highlight progress so far and debate if it's time for much larger studies -- even whether DBS might be tweaked to help people with traumatic brain injuries, such as Iraq war veterans.
"There's not enough awareness of what the potential is of ths kind of stimulation," says meeting co-chair Dr. Margaret Giannini, who heads the government's Office on Disability.
It's not clear who should have DBS in which spot, or if there are still other target areas. Much of the research has been funded by electrode manufacturers."
They're gettting there people! If this doesn't show that depression is a real mental illness, I don't know what does. It's real! It's not a personality flaw or weakness. Hang on everyone. There's a lot of promising research going on that could help.
"It's a new frontier for psychiatric illness: Brain pacemakers that promise to act as anti-depressants by changing how patients' nerve circuitry fires.
Scientists already know the power of these devices to block the tremors of Parkinson's disease and related illnesses; more than 40,000 such patients worldwide have the implants.
But psychiatric illnesses are much more complex and the new experiments with so-called deep brain stimulation, or DBS, are in thier infancy. Only a few dozens patients with severe depression or obsessive-compulsive disorder so far have been treated in closely monitored studies.
Still, the early results are promising. Dramatic video shows one patient visibly brightening as doctors turn on her brain pacemaker and she says in surprise: "I'm starting to smile." And new reports this month show that some worst-case patients -- whose depression wasn't relieved by medication, psychotherapy, even controversial shock treatment -- are finding lasting relief.
Six of 17 severly depressed patients were in remission a year after undergoing DBS and four more markedly improved, and more than half of 26 obsessive-compulsive patients showed substantial improvement over three years, say studies from a team at the Cleveland Clinic, Brown University, and Belgium's University of Leuven.
"Not all patients get better, but when patients respond, it's significant," says Dr. Helen Mayberg of Emory University, who has implanted about 50 depression patients. Her first remains in remission after five years; she estimates that four of every six show enough improvement to be classified "responders".
"We're rewiring the brain in many ways", says Dr. Ali Rezai, chief of the Cleveland Clinic's Center for Neurologic Restoration.
There's a need for innovative therapies. Up to 20 percent of depression patients and 10 percent of those with obesessive-compulsive disorder are treatment-resistant -- several million people in the U.S. alone.
The rationale behind DBS is credible, says Dr. Wayne Goodman of the National Institute for Mental Health: Surgery sometimes helps worst-case patients by destroying misfiring patches of brain tissue. The electrodes are placed into similar spots, but don't destroy tissue -- the electrical sinals can be adjusted and turned off.
But it's not yet ready for prime-time, Goodman cautions. He worries that because the electrodes already are widely available, centers without proper training will start offering the $40,000 implant surgeries to psychiatric patients beforescience prove if they're really valuable.
"It is an invasive, experimental procedure," he warns, with risks including bleeding in the brain and infections. He calls DBS "the last resort for stringently selected patients."
Earlier this month, federal health officials and the Cleveland Clinic brought together the field's leading researchers to highlight progress so far and debate if it's time for much larger studies -- even whether DBS might be tweaked to help people with traumatic brain injuries, such as Iraq war veterans.
"There's not enough awareness of what the potential is of ths kind of stimulation," says meeting co-chair Dr. Margaret Giannini, who heads the government's Office on Disability.
It's not clear who should have DBS in which spot, or if there are still other target areas. Much of the research has been funded by electrode manufacturers."
They're gettting there people! If this doesn't show that depression is a real mental illness, I don't know what does. It's real! It's not a personality flaw or weakness. Hang on everyone. There's a lot of promising research going on that could help.
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I always knew for a fact that my Severe depression is caused by something in my brain that is not working right. I can actually feel it deep inside my head when the pain and torment flairs up. It feels almost physical deep within my brain. Kind of like my brain feels like it could spill out from my head. It's also a somewhat disorienting feeling.
Meds help, but I always have to change them every year or two because I build med resistance fast.
I'm 38 now, sure hope I am not too old if and when this treatment becomes common and well proven.