Can Brain Stimulation Help with Depression?

Mental health professionals have long debated about the merits of brain stimulation for psychiatric disorders. A article published in Medical News Today, May 6, 2009, “Cortical Brain Stimulation Offers Hope To People With Treatment-Resistant Major Depression, “examines this issue. The article reports that the “…results of this study, Long Term Follow-up of Cortical Stimulation to Treat Major Depressive Disorder, were presented …during the 77th Annual Meeting of the American Association of Neurological Surgeons in San Diego.” The researechers “….used an investigational epidural cortical stimulation system to deliver targeted stimulation to the left DLPFC in 12 patients with MDD….The 12 patients were randomized to single blind active or sham stimulation for 8 weeks, and then all subjects received active stimulation. One patient was excluded from analysis due to a protocol deviation. During the procedure, the electrodes were placed epidurally, outside the dura, through a small craniotomy. Outcome assessments included the Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Depression Rating Scale (HDRS), and the Global Assessment of Functioning (GAF). The results of the study were interesting. “At 8 weeks, HDRS decreased by 22 percent (active: n=6) versus 3 percent (sham: n=5)…MADRS decreased 22 percent (active) versus 8 percent (sham)…GAF increased 23 percent (active) versus 12 percent (sham)….In all patients, continued improvement was seen at 6 months (average HDRS: 20 percent) and 12 months (average HDRS: 33 percent)…At 12 months, patients whose electrodes were implanted >20 mm from the precentral sulcus averaged a 59 percent improvement in HDRS compared to a 12 percent improvement in patients (n=6) with electrodes <20mm from the precentral sulcus…Four patients with electrodes <20mm from the precentral sulcus elected electrode revision surgery.” There are several important implications of this study. First, patients with treatment resistant depression should consult a qualified mental health professional to determine if this procedure is right for them. Second, the researfchers note that this procedure is “…is reversible, nondestructive, less invasive than other forms of stimulation, and can be modified by adjustment of the stimulator settings after implantation.”

The Bottom Line: The results of this study suggest that deep brain stimulation may be a viable treatment for treatment resistant depression in selected patients.

Reference: The original article

Resources:

How to improve your understanding of depression. View this top rated video from Youtube:

Ten Great Books on Depression

1. Anxiety & Depression Workbook For Dummies (For Dummies (Psychology & Self Help)) (Paperback) by Charles H., PhD Elliott (Author), Laura L., PhD Smith (Author), Aaron T., MD Beck (Author)
2. Depression for Dummies (Paperback) by Laura L., PhD Smith (Author), Charles H., PhD Elliott (Author)
3. Overcoming Depression One Step at a Time: The New Behavioral Activation Approach to Getting Your Life Back (New Harbinger Self-Help Workbook) (Paperback) by Michael E., Ph.D. Addis (Author), Christopher R. Martell (Author)
4. Overcoming Depression: A Step-by-Step Approach to Gaining Control Over Depression (Paperback) by Paul Gilbert(Author)
5. Overcoming Depression, 3rd edition by Demitri Papolos (Paperback - Jan 10, 1997)
6. Overcoming Depression (Victory Over the Darkness) by Neil T. Anderson and Joanne Anderson (Paperback - Jul 2004)
7. Woman's Guide to Overcoming Depression, A by Archibald Hart and Catherine Hart Weber (Mass Market Paperback - Nov 1, 2007)
8. Overcoming Anxiety and Depression: Practical Tools to Help You Deal with Negative Emotions by Bob Phillips (Paperback - Aug 15, 2007)
9. Overcoming Depression (Overcoming) by Paul Gilbert (Paperback - May 25, 2000)
10. Overcoming Anxiety, Panic, and Depression: New Ways to Regain your Confidence by James Gardner, Arthur H. Bell (Paperback - Feb 1, 2005)

Twelve Resource and Support Groups for Depression

1. Broken Smiles 
2. Journey Towards Freedom
3. Depression Forums
4. Depression Boards  
5. Depression Resources
6. Depression Understood  
7. Depressionsupport1  
8. Yahoo Depression Support Groups
9. The Depression Support Group
10. Depression and Bipolar Support
11. Alliance
12. Families for Depression Awareness

Great Informational Websites Created by Dr. Speller and Dr. Korkosz:

• Stress and the Human Brain
• Early Life Stress and the Immune System

Sources: National Institute of Mental Health, See blogposts in Psychiatric Disorders: General and Psychiatric Disorders: Depression, Youtube

Reference: Medical News Today, February 3, 2009, “Postpartum Depression Predicted By Elevated Levels Of Pregnancy Hormone.”

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Dr. Jeffrey Speller

Dr. Tanya Korkosz

Psychopharmacology Associates of New England

www.psychopharmassociates.com