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

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

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