Navigation Links
Deep brain stimulation shows promising results for unipolar and bipolar depression
Date:1/2/2012

ATLANTAA new study shows that deep brain stimulation (DBS) is a safe and effective intervention for treatment-resistant depression in patients with either unipolar major depressive disorder (MDD) or bipolar ll disorder (BP). The study was published Online First by Archives of General Psychiatry, one of the JAMA/Archives journals.

The study was led by Helen S. Mayberg, MD, professor in the Departments of Psychiatry and Behavioral Sciences and Neurology at Emory University School of Medicine, with co-investigators Paul E. Holtzheimer, MD, lead psychiatrist and now associate professor and director of the Mood Disorders Service, Dartmouth Medical School, and neurosurgeon Robert E. Gross, MD, PhD, associate professor in the Departments of Neurosurgery and Neurology at Emory. Gross served as chief neurosurgeon for the study.

"Depression is a serious and debilitating medical illness," says Mayberg. "When we found that the potential for effective and sustained antidepressant response with DBS 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."

An earlier study by Mayberg done in Toronto in collaboration with scientists at Toronto Western Hospital, University Health Network and Emory, was the first to show such results for patients with treatment-resistant major depressive disorder. Mayberg conducted this new expanded trial at Emory to include patients with bipolar ll disorder.

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.

DBS 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 DBS 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 study.

A significant decrease in depression and increase in function were associated with continuing 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 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."


'/>"/>

Contact: Kathi Baker
kobaker@emory.edu
404-727-9371
Emory University
Source:Eurekalert

Related biology news :

1. Penn biophysicists create new model for protein-cholesterol interactions in brain and muscle tissue
2. During exercise, the human brain shifts into high gear on alternative energy
3. Millisecond brain signals predict response to fast-acting antidepressant
4. Food for thought -- regulating energy supply to the brain during fasting
5. Risk and reward compete in brain
6. Brainy genes, not brawn, key to success on mussel beach
7. Brain-nourishing molecule may predict schizophrenia relapse
8. Brain structure provides key to unraveling function of bizarre dinosaur crests
9. MU brain imaging center provides research for autism, schizophrenia and Parkinsons disease
10. Key to function of dinosaur crests found in brain structure
11. Emotion and scent create lasting memories -- even in a sleeping brain
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/14/2017)... , June 15, 2017  IBM (NYSE: IBM ) ... international tech event dedicated to developing collaboration between startups and ... on June 15-17. During the event, nine startups will showcase ... value in various industries. France ... the international market, with a 30 percent increase in the ...
(Date:5/16/2017)... May 16, 2017  Veratad Technologies, LLC ( www.veratad.com ... age and identity verification solutions, announced today they will ... 2017, May 15 thru May 17, 2017, in ... International Trade Center. Identity impacts the ... in today,s quickly evolving digital world, defining identity is ...
(Date:5/6/2017)... SINGAPORE , May 5, 2017 ... has just announced a new breakthrough in biometric ... that exploits quantum mechanical properties to perform ... new smart semiconductor material created by Ram Group ... across finance, entertainment, transportation, supply chains and security. ...
Breaking Biology News(10 mins):
(Date:10/10/2017)... ... 10, 2017 , ... San Diego-based team building and cooking events company, Lajollacooks4u, ... The bold new look is part of a transformation to increase awareness, appeal ... growth period. , It will also expand its service offering from its signature gourmet ...
(Date:10/10/2017)... ... October 10, 2017 , ... For the second time ... US2020 STEM Mentoring Award. Representatives of the FirstHand program travelled to Washington, D.C. ... US2020. , US2020’s mission is to change the trajectory of STEM education in ...
(Date:10/10/2017)... International research firm Parks Associates announced today that Tom ... 2017 Annual Meeting , October 11 in Scottsdale, Arizona ... and how smart safety and security products impact the competitive landscape. ... Parks Associates: Smart Home Devices: Main Purchase Driver ... "The residential security market has experienced continued growth, and ...
(Date:10/10/2017)... ... October 10, 2017 , ... USDM ... firm for the life sciences and healthcare industries, announces a presentation by Subbu ... , The presentation, “Automating GxP Validation for Agile Cloud Platforms,” will present a ...
Breaking Biology Technology: