Navigation Links
Deep brain stimulation successful for treatment of severely depressive patient
Date:1/8/2010

A team of neurosurgeons at Heidelberg University Hospital and psychiatrists at the Central Institute of Mental Health, Mannheim have for the first time successfully treated a patient suffering from severe depression by stimulating the habenula, a tiny nerve structure in the brain. The 64-year-old woman, who had suffered from depression since age 18, could not be helped by medication or electroconvulsive therapy. Since the procedure, she is for the first time in years free of symptoms.

Scientific studies have shown that the habenula is hyperactive in depression, the idea was to downregulate this structure by deep brain stimulation. The surgical procedure is based on a hypothesis of how the habenula is involved in depression that was first formulated by Dr. Alexander Sartorius, psychiatrist at the Central Institute for Mental Health (CIMH; Director: Professor Andreas Meyer-Lindenberg; former Director CIMH Professor Fritz Henn, Brookhaven National Laboratory, New York). The stereotactic procedure at the Neurosurgery Department of Heidelberg University Hospital (Medical Director: Professor Andreas Unterberg) was performed by Dr. Karl Kiening, head of stereotactic neurosurgery. The concept of habenula stimulation and the case study were published in the leading scientific journal Biological Psychiatry.

A new treatment option for therapy-resistent depression

Depression is a common psychiatric illness; some one third of patients do not respond to medication or psychotherapy. Electroconvulsive therapy, used for such severe or treatment resistant cases, is also not always effective. This was also the case for the Heidelberg/Mannheim patient, who never reached sustained remission after electroconvulsive therapy.

In deep brain stimulation, electrodes are inserted into the brain and are connected with wires under the skin to an electronic impulse generator implanted in the chest. The electrodes emit current that continuously stimulates specific areas of the brain. This therapy, also described as "brain pacemaker", is already used successfully for patients suffering from Parkinson's disease or other movement disorders.

Depressive patients have already been treated with electrostimulation with some success. However, two other areas of the brain were stimulated, located in the forebrain or midbrain regions. The habenula (Latin for the diminutive of reins) is located further downstream next to the brain stem. "We decided to stimulate the habenula because it is involved is the control of three major neurotransmitter systems, which are known to be disturbed in depression,'" explained psychiatrist Dr. Alexander Sartorius from the Central Institute of Mental Health.

The neurosurgical implantation of two electrodes demands utmost precision in planning and performance. The target area is about half as large as the others that are typically targeted for movement disorders, and in addition, is located in the middle of the brain, i.e. in the wall of what is known as the 'third ventricle'. Implanting the electrodes in the two habenulae therefore requires the utmost precision that can currently be achieved with stereotactic instruments. "The neurosurgery department at Heidelberg University Hospital is optimally equipped for demanding procedures such as this with among other things, the new intraoperative highfield MRI," says Dr. Kiening.

Multicenter study on habenula stimulation in preparation

The success of the procedure was confirmed when the electrode was accidentally switched off: the patient had a bicycle accident which required surgery for which an ECG had to be made as preparation. The brain pacemaker was switched off and was not reactivated for a few days, and the depression promptly returned. A few weeks after reactivation, the patient completely recovered again.

The neurosurgeons in Heidelberg and the psychiatrists in Mannheim now want to build on this positive experience and are planning a clinical study in which the habenula stimulation is to be implemented for severely depressive patients at five psychiatric-neurosurgery centers in Germany. "We aim to show that habenula stimulation has a better success rate than other target areas attempted for depression and that it is also safe to use," says Dr. Sartorius, Coordinating Investigator of the proposed study.


'/>"/>

Contact: Dr. Karl Kiening
Karl.Kiening@med.uni-heidelberg.de
49-622-156-8017
University Hospital Heidelberg
Source:Eurekalert  

Related medicine news :

1. Ginkgo Wont Slow Decline of Aging Brain
2. Bedside Exam Trumps Scan for Post-Brain Surgery Monitoring
3. bioMerieux Selects Brainware to Automate Accounts Payable
4. Neuroscientists at Case Western Reserve University store information in isolated brain tissue
5. Gene Mutations Behind Brain Reduction
6. Two Genes Work in Tandem to Spur Deadliest Brain Cancer
7. Brain training can help improve specific abilities in older people
8. Medical Doctor Proposes New Brain Function Theory
9. Protein link may be key to new treatment for aggressive brain tumor
10. Brain Imaging Sheds Light on Social Woes Related to Autism
11. For older adults, participating in social service activities can improve brain functions
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Deep brain stimulation successful for treatment of severely depressive patient
(Date:2/26/2017)... , ... February 26, 2017 , ... IndustryArchive.Org . ... with Pay-For-Performance B2B Marketing. B2B Sellers will now only pay for B.A.N.T. quality sales ... the founder of IndustryArchive.Org, said, “Given the new reality that B2B buyers are controlling ...
(Date:2/25/2017)... (PRWEB) , ... February 25, 2017 , ... FCPX users ... Color tools from Pixel Film Studios. With ProSharpen Color users have total control over ... easily refine their color range. With color spectrum tools users can visually see the ...
(Date:2/24/2017)... Pittsburgh, PA (PRWEB) , ... February 24, 2017 , ... ... by researchers at the University of Pittsburgh points to eight genes that may explain ... the other, according to the results of a study published today in the journal ...
(Date:2/24/2017)... , ... February 24, 2017 , ... Healthcare Associates ... Medical Center at Craig Ranch building at 8080 State Highway 121, Suite 210, McKinney, ... with easy access to Highway 121. , As the practice has grown, the need ...
(Date:2/24/2017)... (PRWEB) , ... February 24, 2017 , ... The International ... 7th annual “Imagine Me Beyond What You See” body image mannequin art competition. Selected ... will be showcased and the winner revealed at the 31st annual iaedp Symposium, March ...
Breaking Medicine News(10 mins):
(Date:2/23/2017)... 23, 2017 ITL Limited, ( ASX: ITD ), an ... the half year ended 31 December 2016 compared with the previous ... can be viewed here . Highlights ... up 104%) Earnings per share of 2.2 cents ... $17.5m (Dec 2015: $15.7m; up 11%) Profit before ...
(Date:2/23/2017)... 23. Februar 2017 Im Rahmen seiner ... Wirtschaftszone in der südwestlichen chinesischen Provinz Guizhou, 2017 mit dem ... Innovationsplattform aktiv an der Entwicklung einer eingebetteten Hightech-Schlüsselindustrie. ... Continue Reading ... ...
(Date:2/23/2017)... , Feb. 23, 2017 AcelRx ... focused on the development and commercialization of innovative ... announced that it will release fourth quarter and ... March 2nd, 2017. AcelRx management will host an ... (1:30 p.m. Pacific Time) on March 2 nd ...
Breaking Medicine Technology: