A recently published multi-center pilot study supports use of deep brain stimulation (DBS) for major depressive disorder for people who have not responded to more traditional modes of treatment.
The study, conducted at three research facilities in Canada, is published online in the Journal of Neurosurgery.
Researchers determined that DBS therapy, targeted to an area of the brain known as Brodmann Area 25, provided noticeable improvement in depression symptoms and increased overall quality of life in patients who typically don’t respond to treatment.
“The reduction in depression scores is clinically significant as these patients had previously tried multiple medications, psychotherapy and/or electroconvulsive therapy (ECT) without success,” said Andres Lozano, M.D., neurosurgeon at Toronto Western Hospital, author of the paper and a primary investigator in the study.
In deep brain stimulation, electrical impulses course through electrodes implanted within the brain, where they are thought to affect brain cells and neurochemical transmitters. It has been used effectively for some other conditions such as Parkinson’s disease and essential tremor, but has not yet been approved by the Food and Drug Administration (FDA) for treating depression.
The study enrolled 21 patients who on average had suffered from depression for 20 years, had tried in excess of 16 depression medications and were considered disabled or unable to work at the time of enrollment.
Investigators discovered that at one year, 62 percent of all patients in the study had a 40 percent reduction in symptoms and 29 percent had symptoms cut in half as measured against their baseline.
“To see 62 percent of the patients in this study respond at one year gives us hope that this research may lead to a therapy for this hard-to-treat patient population,” Lozano said.
Patients in the study were also evaluated using a Clinical Global Impression of Severity (CGI-S) rating scale that measures the severity of their illness. Before DBS, 70 percent of the patients were categorized as severely or extremely ill. After 12 months of DBS, over 80 percent of the patients experienced improvement and none of the patients were rated as severely or extremely ill.
Additionally, eight of the study patients returned to daily life activities such as work, school and sustaining relationships with family and friends, and two patients were considered to be in remission.
“These findings are significant as they confirm the basis on which we established the BROADEN pivotal study,” said Rohan Hoare, Ph.D., president of St. Jude Medical Neuromodulation Division. “These results add to the growing evidence suggesting that DBS therapy may help patients who currently don’t have an adequate treatment option in managing severe depression.”
Source: St. Jude Medical