Depression is one of the most common psychiatric disorders, affecting up to 264 million people worldwide. It is also the primary cause of hundreds of thousands of deaths per year. But as many as 30 percent of patients do not respond to standard treatments such as medication or psychotherapy. Some of these individuals respond positively to electroconvulsive therapy (ECT), but stigma and side effects make ECT undesirable for many, and one in ten patients experience little to no benefit from ECT so other solutions are needed.
One such option showing promise is targeted neuromodulation tailored to individual patients' distinctive symptoms. This approach is an increasingly common way of correcting misfiring brain circuits in people with epilepsy or Parkinson's disease.
Scientists at UC San Francisco's Dolby Family Centre for Mood Disorders have -- at least in one patient -- demonstrated a novel personalized neuromodulation approach that was able to provide relief from symptoms of severe treatment-resistant depression within minutes.
This approach is now being developed as a potential treatment for the significant percentage of people with debilitating depression who do not respond to existing therapies and of which are at high risk of suicide.
"The brain, like the heart, is an electrical organ, and there is a growing acceptance in the field that the faulty brain networks that cause depression -- just like epilepsy or Parkinson's disease -- could be shifted into a healthier state by targeted stimulation," said Katherine Scangos, MD, PhD, an assistant professor in the Department of Psychiatry and Behavioural Sciences and corresponding author of the new study. "Prior attempts to develop neuromodulation for depression have always applied stimulation in the same site in all patients, and on a regular schedule that fails to specifically target the pathological brain state. We know depression affects different people in very different ways, but the idea of mapping out individualized sites for neuromodulation that match a patient's particular symptoms had not been well explored."
In a case study as recent as January 2021 showed improvements in a patient with severe treatment-resistant depression. By stimulating different sites of the patient’s brain, they could alleviate distinct symptoms of the brain disease -- reducing anxiety, boost energy levels, and restore pleasure in everyday activities. This was able to clearly highlight the benefits of different stimulation sites depended on the patient's mental state at the time. A 5-year study in about to get underway in this exciting new area of brain research.