Brain 'Pacemaker' May Ease Depression
Surgical technique seems to help those seemingly with no hope
(HealthDay News) -- Most people with depression can get relief from medication, psychotherapy and, in extreme cases, electroconvulsive therapy. But what happens when the depression lingers despite treatment?
A small study offers hope. Researchers found that by inserting two tiny "pacemakers" into the base of the brain, people suffering from major depression improved.
The treatment, called deep-brain stimulation, utilizes tiny pulses of electricity to block abnormal brain activity, the researchers said.
"It was interesting and impressive to see how their lives changed over time," study author Dr. Ali R. Rezai, a neurosurgeon with the Cleveland Clinic Foundation, told HealthDay. "They went from being withdrawn and not interacting to going back to work and showed marked improvement in self care and social function."
People who had this treatment "are living their lives much more fully than they were when they were stuck in the grip of depression," Rezai said.
The researchers inserted pairs of the tiny electrodes into six people who had failed to benefit from other forms of treatment. Over the course of a year, four of the six (two-thirds) showed marked improvement, the researchers said.
Deep-brain stimulation surgery has proved successful in the past for people suffering from obsessive-compulsive disorder, epilepsy and Parkinson's disease, Rezai said. Experts don't understand exactly why it works, but it seems to help the brain resume normal electrical and chemical function.
The surgery is reversible, Rezai said, and the electrodes can be adjusted without further invading the brain. It is performed under a local anesthetic, and, in some cases, the change in people "could be seen almost instantly," he said.
"As we were testing the pacemakers [during the surgery], we could see immediate change in their moods," he said, adding that people smiled who hadn't smiled in years.
"But," he cautioned, "this is for people with no other hope. These poor patients had failed everything. I am encouraged by the results, but we need to do more long-term and larger studies."
Depression is a global health-care concern, with the World Health Organization rating major depression the top cause of disability worldwide, the researchers said. More than 17 million American adults have been diagnosed with major depression, according to the U.S. Department of Health and Human Services.
Signs of depression, according to the U.S. Food and Drug Administration, include:
When things that used to make you happy don't make you happy anymore.
Having no interest in eating.
Eating too much or all the time.
Sleeping too little or all the time.
Feeling tired all the time.
Feeling nervous or cranky.
Crying a lot.
Having trouble paying attention.
Thinking of death or trying to kill yourself.
Anyone who has some of these signs for more than two weeks could be depressed and should see a doctor right away.
On the Web
To learn more about major depression, visit the National Alliance on Mental Illness.
SOURCES: HealthDay News; Ali R. Rezai, M.D., head, Section of Stereotactic and Functional Neurosurgery, Cleveland Clinic Foundation; U.S. Food and Drug Administration (www.fda.gov); National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration (www.oas.samhsa.gov)
Author: Anne Thompson
Publication Date: April 30, 2007
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