DBS for Depression: Still Mixed ResultsDeep brain stimulation (DBS) is a treatment long used for Parkinson’s disease. But in the past decade, some researchers have also examined its use for the treatment of severe clinical depression.

Severe major depression is a serious problem in society, because some studies estimate that up to 30 percent of those who attempt to be treated for it find they have “treatment resistant” depression — that is, traditional treatments simply don’t work very well.

Deep brain stimulation has mixed results. As we reported on back in February, a long-term followup of 20 patients found an average response rate to DBS of 64 percent. Not shabby, but also not the hopeful, guaranteed cure it was once held out to be.

Maiken Scott, the behavioral health reporter for Philadelphia station WHYY, has a story following a handful of patients in a local clinical trial looking into the effectiveness of DBS for depression.

DBS involves placing tiny electrodes deep inside the brain, and then delivering small electrical pulses (“stimulation”) through those electrodes that target key circuits in the brain. It has a long history of helping to alleviate Parkinson’s disease symptoms when Parkinson’s disease medications start to become ineffective. Researchers noticed DBS appeared to help with Parkinson’s patients’ mood as well, so they began testing it on severely depressed patients where other, more traditional methods of treatment — such as antidepressant medications and psychotherapy — failed.

Depression sufferer Tara Aliotta has tried everything from hospitalizations to dozens of different kinds of medications. Nothing has touched her depression. So she was all for trying DBS as well, but to no effect:

Aliotta and her team try different settings, medications. Nothing helps. In early 2011, it’s clear DBS is not working for her. The electrodes are shut off. In April she returns to the hospital to have them removed. Once again, her parents are with her, looking still more worried and worn. Tara looks fragile and child-like in her hospital gown. She says she simply doesn’t know where to go from here, and admits that she thinks about death all of the time.

Others fare better on DBS:

Other study participants are doing better. Ciara, a woman in her thirties, is seeing benefits. “I used to carry around this huge weight on my chest that just hurt all the time,” Ciara says, “and it never ever went away, and I feel like that’s gone. I talk now. I can actually read a book.”

The Philadelphia study showed mixed results, in line with most studies examining DBS for depression:

As a whole, the study has shown mixed results for DBS in treating depression. In Philadelphia, four participants got a lot better. The other four saw no improvement. But [researcher] O’Reardon says DBS is by no means finished as a tool in treating depression. He says this point doesn’t mark an end, it marks the end of the beginning phase. “We have learned a lot, and we want to apply that in future studies, so that we will move along this road positively,” said O’Reardon.

Next steps for researchers is to try and figure out why deep brain stimulation works for some patients, and not others.

Because if they can answer that question, then it becomes far easier to offer the treatment to people when you know it has a high probability of succeeding (rather than offering people the false hope of relief from their depression symptoms).

Read the full article: One chance left: one woman’s battle to beat depression

 


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    Last reviewed: By John M. Grohol, Psy.D. on 29 Jul 2011
    Published on PsychCentral.com. All rights reserved.

APA Reference
Grohol, J. (2011). DBS for Depression: Still Mixed Results. Psych Central. Retrieved on September 2, 2014, from http://psychcentral.com/blog/archives/2011/07/29/dbs-for-depression-still-mixed-results/

 

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