“Depression is a serious and debilitating medical illness,” says study author Helen S. Mayberg. “When we found that the potential for effective and sustained antidepressant response with deep brain stimulation for patients with otherwise treatment resistant major depressive disorder was high, the next step was to determine if patients with intractable bipolar depression could also be successfully treated.”
Research Shows Deep Brain Stimulation Effective For Depression
Bipolar spectrum disorder, sometimes referred to as manic-depression, is characterized by bouts of mania or hypomania alternating between episodes of depression. Although people with bipolar ll disorder do not have full manic episodes, depressive episodes are frequent and intense, and there is a high risk of suicide. A major challenge in treating bipolar depression is that many antidepressant medications may cause patients to “switch” into a hypomanic or manic episode.
Deep brain stimulation uses high-frequency electrical stimulation targeted to a predefined area of the brain specific to the particular neuropsychiatric disorder. Here, each study participant was implanted with two thin wire electrodes, one on each side of the brain. The other end of each wire was connected under the skin of the patient’s neck to a pulse generator implanted in the chest – similar to a pacemaker – that directs the electrical current.
Study participants received single-blind stimulation for four weeks (patients did not know if the deep brain stimulation system was on or off), followed by active stimulation for 24 weeks. Patients were evaluated for up to two years following onset of active stimulation. Seventeen patients were enrolled in the deep brain stimulation study.
A significant decrease in depression and increase in function were associated with continuing deep brain stimulation. Remission and response rates were 18 percent and 41 percent after 24 weeks; 36 percent and 36 percent after one year and 58 percent and 92 percent after two years of active stimulation. Patients who achieved remission did not experience a spontaneous relapse. Efficacy was similar for Major Depressive Disorder and Bi-Polar patients, and no participant experienced a manic or hypomanic episode.
Mayberg and her colleagues continue to refine this intervention. Current studies include demographic, clinical and imaging predictors of response and remission, and introduction of psychotherapeutic rehabilitation. Why and how this treatment works is the primary focus of ongoing research.
“Most of these patients have been in a depressed state for many years and are disabled and isolated,” says study author Paul E. Holtzheimer. “As their depression improves, they need a process to help them achieve full recovery that includes integration back into society.
“We hope to optimize the rate of improvement for these patients by using a model of care that provides psychotherapeutic rehabilitation built on evidence-based psychotherapy but tailored to the specific individual’s situation.”
Reference for: Research Shows Deep Brain Stimulation Effective For Depression
41233 
