Severe depression treatment and deep brain stimulation

Severe depression treatment and deep brain stimulation
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World’s largest study of deep brain stimulation in the brain’s reward system was conducted providing sustained relief can patients use this as a form of severe depression treatment?

Published in the journal Neuropsychopharmacology, patients suffering from severe, treatment-resistant depression can benefit not only acutely but also the long-term from deep brain stimulation, as researchers from the Medical Center – University of Freiburg and their colleagues from the University Hospital Bonn, Germany, demonstrate in a current study. Could this really be a form of severe depression treatment?

Deep brain stimulation and electrodes

The team used thin electrodes to stimulate a deep-seated part of the reward system in the brains of 16 patients. This led to a significant reduction of ratings of depression severity in all patients, it was reduced by half on average.

For half of the study participants it was even reduced below the level regarded as the threshold for a depression requiring treatment. Most of the patients experienced those positive stimulation effects within the first week, and they lasted throughout the course of the one-year study.

Professor Dr. Thomas Schläpfer, head of the division of interventional biological psychiatry at the medical center, University of Freiburg, explains: “The most compelling outcome from the study is the sustained efficacy in very severely ill patients.

“Most treatments in psychiatry cease to be efficacious after months and years, we demonstrated for the first time in demonstrating in a relatively large-scale study that deep brain stimulation is a real option for those patients suffering from treatment-resistant, severe depression.”

Finally, a successful form of severe depression treatment

An estimated 10 to 30 percent of all people with recurring depression do not respond to approved treatments. Deep brain stimulation could be a treatment option for some of these patients. The 16 participants in the FORSEE-II study had suffered from severe depression for 8 to 22 years and had previously undergone an average of 18 drug therapies, 20 electroconvulsive therapies, and 70 hours of psychotherapy – without success.

The researchers implanted the deep brain stimulation systems in the patient’s medial forebrain bundle of the brain and used them to stimulate the medial forebrain bundle. This brain region is involved in the perception and regulation of pleasure and reward and is thus also significant for motivation and the perceived quality of life.

Severe depression treatment that could be long lasting

The doctors evaluated the success of the therapy monthly with the help of the established Montgomery-Asberg Depression Rating Scale (MADRS). The MADRS scores of ten study participants already decreased significantly within the first week and remained at a low level.

Schläpfer adds: “Our patients had struggled with severe depression for years with no signs of improvement. Deep brain stimulation brought most of them significant relief within days, which lasted throughout the course of the therapy. Other forms of treatment like medication and psychotherapy often lose their effectiveness over the course of time.

“Absolutely sensational about the study data is that the effect seems to be long lasting, with the positive effects continuing for years”.

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