Brain Pacemaker Relieves Severe DepressionBrain pacemakers deliver positive long-term effects in severely depressed individuals, according to scientists at the Bonn University Medical Center.

Of the eleven participants who took part in the study over a period of two to five years, almost half experienced a long-term reduction in symptoms of more than 50 percent.

Typically, individuals with depression are treated with psychotherapy and medication.

“However, many patients are not helped by any therapy,” said Dr. Thomas E. Schläpfer from the Bonn University Medical Center for Psychiatry and Psychotherapy.  “Many spend more than ten years in bed — not because they are tired, but because they have no drive at all and they are unable to get up.”

An effective alternative is “deep brain stimulation,” in which electrodes are implanted in the person’s brain. In this procedure, a weak electrical current stimulates the nucleus accumbens, the part of the brain responsible for feelings of gratification.

These types of pacemakers are commonly used by neurosurgeons and neurologists to treat continuous muscle tremors in Parkinson’s disease.

Previous research has shown that brain pacemakers produce effects in the most severely depressed patients. In a previous study, ten subjects who had undergone implantation of electrodes in the nucleus accumbens all experienced relief of symptoms. Half of these felt a significant difference.

“In the current study, we investigated whether these effects last over the long term or whether the effects of the deep brain stimulation gradually weaken in patients,” said Schläpfer.

Many patients in the study had already gone through up to 60 treatments with psychotherapy, medications and electroconvulsive therapy with no success.

“By contrast, in the case of deep brain stimulation, the clinical improvement continues steadily for many years,” said Schläpfer.  “Those who initially responded to the deep brain stimulation are still responding to it even today.”

During the study, one patient committed suicide. “That is very unfortunate,” he said. “However, this cannot always be prevented in the case of patients with very severe depression.”

Even after a short period of time, the participants showed an improvement in symptoms. “The intensity of the anxiety symptoms decreased and the subjects’ drive improved,” said Schläpfer.  “After many years of illness, some were even able to work again.”

“An improvement in symptoms was recorded for all subjects; for nearly half of the subjects, the extent of the symptoms was more than 50 percent below that of the baseline, even years after the start of treatment,” he said. “There were no serious adverse effects of the therapy recorded.”

The current study proves the method’s long-term effectiveness and may offer hope for those who suffer from the most severe forms of depression.

“However, it will still take quite a bit of time before this therapeutic method becomes a part of standard clinical practice,” said Schläpfer.

The results are in the current edition of the journal  Neuropsychopharmacology.

Source:  Bonn University Medical Center