Technology could offer a solution to treatment-resistant depression, where antidepressants don’t work effectively, a new study has shown.
Patients were treated with implanted electrodes in the brain (known as deep brain stimulation or DBS) and saw significant brain changes over a year.
Patients involved in the study also reported that their depression had eased, the researchers say.
DBS is already widely used to treat conditions such as Parkinson’s.
That makes it a strong potential therapy for treatment-resistant depression, the UTHealth Houston researchers believe.
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Christopher Conner, MD, PhD, a former neurosurgery resident at UTHealth Houston says, “This is something that people have been trying to do for a long time, but we have not always been very successful with using DBS for psychiatric illnesses.
“But this PET study shows that we’re altering how the brain is functioning long term and we are starting to change the way brain starts to organise itself and starts to process information and data.”
For years, DBS has been studied as a possible treatment for patients with treatment-resistant depression.
In DBS, electrodes are implanted into certain brain areas, where they generate electrical impulses to affect brain activity.
However, finding what part of the brain needs to be targeted to treat depression long term has been challenging.
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Conner said, “We targeted a bundle of fibers that leave this small area in the brainstem to travel to other areas throughout the brain.
“The PET scans indicated that this small target area has very diffuse downstream effects. It’s not one single effect because there’s not one single area of the brain linked to depression. The whole brain needs to be changed and through this one small target, that’s what we were able to do.”
Researchers performed an initial PET scan before the DBS procedure on the 10 patients in the study for a baseline image.
They performed additional PET scans at six and 12 months to assess changes after treatment.
Scans of 8 of the 10 patients showed a response.
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Co-author Professor João de Quevedo of McGovern Medical School said, “A responder to the treatment means that your depression potentially decreases at least 50%; you’re feeling much better.
“So, for patients with severe chronic treatment-resistant depression, decreasing our symptoms by half is a lot. It’s the difference between being disabled to being able to do something.
“Correlating with the PET image changes, our patients reported that their depression lessened after the treatment.”
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