A Surgically Implanted Brain Stimulation Device Could Help Treat Severe Depression (theverge.com) 90
An anonymous reader quotes a report from The Verge: Sarah was the patient in a proof-of-concept trial of a new approach to treating severe, treatment-resistant depression, published today in the journal Nature Medicine. The findings open up another possible strategy for helping people with the disorder. The study only involved Sarah, and it's still not clear how well it might work in other people. The lessons from the trial, though, helped the researchers understand more about the nature of depression and could apply to other efforts to treat the disease. The trial used a technique called deep brain stimulation, where electrodes implanted within the brain deliver electrical impulses in an attempt to change or regulate abnormal brain activity. It's common for conditions like epilepsy and Parkinson's disease. Research over the past decade has shown that it can sometimes help with depression, but the findings have been inconsistent. Most previous efforts delivered stimulation to individual regions of the brain thought to be involved in depression. This study, though, was targeted at regions that were part of specific brain circuits -- interconnected parts of the brain that are responsible for specific functions.
In addition, the circuits involved might be different for each person. So in this trial, the study team personalized the treatment approach to the specific patient's depression. They mapped out the type of brain activity that occurred when Sarah's depression symptoms flared. Then, they surgically implanted a device that could detect that brain activity and send stimulation to the circuit where the activity was happening. For Sarah, the procedure was highly effective. Her scores on depression rating scales dropped the morning after the device was turned on. And perhaps more importantly, she felt dramatic changes in her mood. During her first time getting the stimulation, she laughed out loud in the lab. "And everyone in the room went, 'Oh my god,' because that's the first time I spontaneously laughed and smiled, where it wasn't faked, in five years," she said. Sarah's depression circuit flares up hundreds of times a day, and each time, the implanted device delivers a brief stimulating pulse. In total, she gets around 30 minutes of stimulation each day [...]. Sarah can't feel the pulses, but she said she does have a general idea of when they're happening throughout the day. "There's a sense of alertness and energy or positivity that I'll feel," she said.
In addition, the circuits involved might be different for each person. So in this trial, the study team personalized the treatment approach to the specific patient's depression. They mapped out the type of brain activity that occurred when Sarah's depression symptoms flared. Then, they surgically implanted a device that could detect that brain activity and send stimulation to the circuit where the activity was happening. For Sarah, the procedure was highly effective. Her scores on depression rating scales dropped the morning after the device was turned on. And perhaps more importantly, she felt dramatic changes in her mood. During her first time getting the stimulation, she laughed out loud in the lab. "And everyone in the room went, 'Oh my god,' because that's the first time I spontaneously laughed and smiled, where it wasn't faked, in five years," she said. Sarah's depression circuit flares up hundreds of times a day, and each time, the implanted device delivers a brief stimulating pulse. In total, she gets around 30 minutes of stimulation each day [...]. Sarah can't feel the pulses, but she said she does have a general idea of when they're happening throughout the day. "There's a sense of alertness and energy or positivity that I'll feel," she said.
Re: Soylent Green... (Score:5, Insightful)
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Spoons? What does that even mean here?
Re: Soylent Green... (Score:1)
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Actual clinical depression is caused by too few catecholamines and/or or too few receptors in the mesolimbus. For acute depression, amphetamine (or methylphenidate) works in 95%+ of people. And then the cruelty of tolerance sets in, and it slowly loses its effectiveness as the body equilibrates. You either have to take more or go without for awhile for it to become effective again. Which is why they do not Rx it for depression.
This womanâ(TM)s brain is adapting, and if they ever take out the device,
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Maybe you should read his comment again, but this time without stopping in the middle (or rather in the very beginning) - he didn't suggest stimulants as treatment, did you not read or comprehend his whole comment?
And when did posting to slashdot mean that one can't possibly know anything about what his talking anyway? Because it seems you're arguing that something must be wrong, because it was posted in Slashdot comment section.
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Yup, dopaminergic stimulants like amphetamine or cocaine are not seen as good medications for depression for a good reason - which is why I'm baffled of bupropion (Wellbutrin, Zyban, Voxra), a potent NDRI (Noradrenaline and Dopamine Reuptake Inhibitor) is sold and prescribed for depression. It's a dopaminergic stimulant, of course it will help with depression - just like coke does. Should it be used for treatment of depression? I'm kinda suspicious if that's a good idea... Is it any better than prescribing
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Re: Soylent Green... (Score:1)
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Next up (Score:2)
An implantable Ritalin pump to regulate her hypeactivity.
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A. Implantable drug delivery devices already exist.
B. Ritalin is used improve the brain's executive function and any changes in behavior are a result of that.
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Ritalin also has poor delivery mechanism. I would rather suggest dextroamphetamine or modafinil, but if it's methylphenidate then Concerta is the drug you should be taking if you want it to carry through the day without so called "roller coaster effect" where the drug kicks in, starts decreasing in effect until the next dose, then raise again and again begins to decrease, until the next dose kicks in, etc. - Concerta will not only release the stuff slowly throughout the day, it will also start releasing str
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It was first prescribed for me in 1970, when I was in second grade.
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Yeah? Interesting...
My country sometimes feels like behind the rest of the world in treatment of certain issues, like ADD/ADHD. In Finland proper treatment of ADD/ADHD with dopamine stimulants really only begun in the early 2000's, which is why I said "Using Ritalin to treat ADHD is so 2000's. And Concerta became to market soon after. There was no treatment or even proper diagnosis for ADD/ADHD before, at least here - what's now known as ADD and ADHD was often diagnosed as MBD, which is an umbrella diagnosi
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In a lot of countries, they don't see it as a disorder at all. It's just a badly behaved kid who needs to be forced into obedience.
I know a better device. It doesn't need implanting (Score:2)
But how long will it work for? (Score:4, Interesting)
It will be an interesting to see if this device is effective in the long term because I recall reading The Terminal Man [wikipedia.org] which is literally about the unintended consequences of implanting a "brain pacemaker" which is literally the same concept as this device. The important part is where the device is connected and what triggers it. After all, you don't want to train your brain to become depressed in order to get zapped, which is effectively what happened in the book but with psychotic rage.
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What if we punish the brain for getting depressed, thereby training it to never be depressed?
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Re: But how long will it work for? (Score:1)
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i didn't get to choose my parents. between heredity and the environment of my growing up, there wasnt much choice that got me where i am today.
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You clearly haven't ever had to deal with depression, either firsthand or seeing a loved one experience it. Sure, some people get depressed because they are in painful and stressful situations, possibly the result of their own life choices (although teasing cause from effect here may be challenging). Others (most?) suffer depression for no discernible reason, even when everything in their lives is hunky-dory. Their
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Saying it "wasn't a choice" is an assumption contradicting the assumption of the GP post. That it wasn't a conscious choice is usually clear, but that's not quite the same thing.
OTOH, the only way I can think to test this would be to study whether practitioners of various schools of meditation get depressed, and there could be a selection effect there, so that would be a tricky study.
N.B.: Being depressed means something quite different in medical language than it does in common speech. The meanings are
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Sure, that was my point.
Gravis Zero said we should be careful not to elicit depression in order to "get zapped", I decided I would flip it to the other extreme. i.e. a sarcastic response.
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That book is fiction, not real. Don't confuse reality with a random speculation. Anyone can imagine anything. You can speculate that someone reads your comment and that causes him to delay having sex which in turn enables his one evil sperm impregnate his wife and he has the next Hitler as a kid. It's possible, isn't it? Anyone can imagine any negative scenario from any given action.
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That book is fiction, not real. Don't confuse reality with a random speculation.
It is fiction but it's based on the same concept as addiction which is very real. Like I wrote, "[t]he important part is where the device is connected and what triggers it," because that will determine if it is habit forming. I'm sure the doctors involved in the invention of the device were well aware of this issue but our understanding of the brain is rather limited. There is really only one way to be sure they've haven't stumbled into doing this inadvertently and that is to wait and see.
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It's not just that: there are conditions that are debilitating enough to take on the risk of habituation or other unknown factors, at least in early phase studies
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"The Terminal Man" was exactly the first thing I thought of.
Hey Scientists -- how about stop using Michael Chriton novels as grant proposals ?
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Science often follow science fiction. There are multiple reasons for this but mostly it's because science fiction writers are writing about technology that has yet to be developed and the desires of man. Some are technologies described are strikingly accurate while many are simply too fantastic.
There are few elements from the stories of man that make them an inevitability. The first is the construction of an artificial person, which may be centuries (if not millennia) away but it will happen. The second
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Science often follow science fiction. There are multiple reasons for this....
No, I think there's only one reason for this: Scifi writers prolifically spitball a nearly infinite number of future scenarios, spanning largely the breadth of human imagination. The ones we remember are the ones who do it well. The ones that don't do it well we forget.
It's survivorship bias.
We don't remember the wacky-ass scifi that got most stuff wrong and was just hilariously wrong about the future. We remember the scifi that got it largely correct, or was an echo of that future, or still is in the futur
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Maybe Critchon just extrapolated inevitable technological trends toward their logical conclusion in applications, and wrote a book around the foreseeable personal and societal impact of that. It feels like it's a straightforward, generative process. Science is usually more difficult, even if it achieves a barely detectable transition toward a hypothesized future realization
Re:But how long will it work for? (Score:5, Informative)
Actually, deep brain stimulation has been around for decades. In some cases, it directly affects the dopamine pathways in the brain, which affect mental health as well as other brain functions. (The mechanism of action for DBS varies on the condition it is treating. In many cases, the precise mechanism of action is still debated.) If The Terminal Man were real, rather than a fun piece of fiction, we probably would have seen such feedback loops by now.
Reading your subject line, I thought you were going to raise the point that, as an implant, deep brain stimulators have a finite life span. Batteries need replacing, sure, but the electrodes too have a finite life. Over time, they gradually become insulated from the rest of the brain - kind of like scar tissue - such that you gradually need to crank up the stimulation to get the same effect. This is probably of little concern to a 75-y.o. patient with an untreatable Parkinson's, who will probably pass away long before this is an issue. But the problem definitely needs further research if we ever want to have widespread adoption of brain-computer interfaces.
For those that are interested in a deeper dive, here is a long (and free) publication from the NIH [nih.gov] surveying the state of DBS.
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"Finite life" is probably still true, but they've made a lot of improvements in the electrodes over the last decade or so. I've no idea what the lifetime is for "state of the art" electrodes, but I *believe* it's currently well over a decade.
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Batteries need replacing, sure, but the electrodes too have a finite life.
Issues with batteries are solvable with wireless charging (yes there are additional safety measures that need to be taken for that but it's doable with current technology) and they have been working on the issue of electrodes, more now than ever. The key to making proper electrodes is to interface like other neuron cells rather than being tiny daggers stabbing the brain. I think some synthetic biology will be needed to fully realize this goal but it's definitely doable. More advanced versions utilizing s
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This is my understanding as well but those are just physical resistance to the electrodes themselves. The neural connections formed to various reward mechanisms in the brain that trigger feelings of happiness may well persist even if the device stops functioning.
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Prior art (Score:2)
The doctors must have read Larry Niven's Know Space stories.
Droud [fandom.com].
Not to be completely negative but I can easily see this tech being used as a "get happy quick" solution to those cases of depression that might not have a neurological cause but would require more effort from the healthcare system than it wants to put out for a single patient.
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Except that it isn't and doesn't.
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And even the summary said this was highly personalized, and based on a measurement of how her brain was reacting during a siege of depression. And that other people had different sections (well, "circuits") of the brain affected.
This approach won't become general purpose until we've got intelligent nano-bots...which won't be anytime soon. (The intelligence wouldn't need to reside within the nanobot, so it's not impossible, but control would be a real problem.)
Batty (Score:2)
This story reminds me of Batty from the movie Ferngully. Just tap the antenna and you get a new personality.
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'The Terminal Man' (Score:2)
Just goes to show (Score:1)
Abnormal brain activity (Score:3, Insightful)
> deliver electrical impulses in an attempt to change or regulate abnormal brain activity
Abnormal uh?
How can you define a thought (which is what brain activity is after all) "abnormal"? Only because a small percent of people experiences it?
This always reminds me how these fools used to "cure" homosexuals because they were thought to be "abnormal" back only a few decades ago. How much pain did they cause for their presumption of knowing how the brain works and what is "normal" and "abnormal"? How many lives did they destroy? How many couples who loved each other did they kept away from each other? How many did they torture (usually teens with idiotic parents) with their pathetic experiments before understanding that THEY were wrong and that there was nothing "abnormal" in how their brain worked?
I'm sure the only reason they changed mind is because they failed at "curing" it again and again and again. If they did succeed, they would still "cure" homosexuality and consider the love between two persons "abnormal" only because it affected a small percent of the general population.
So, again, how can they now say "this is abnormal" if we do NOT have the service manual of the brain and it is one of the most complex and less understood machines in the universe? Did they not learn anything from their recent story? How do you know if the software inside our brain is working correctly or not if we can't even prove a software WE wrote is correct or not?
Yes, depression is a bad thing and whoever experienced it at least once in their life can tell you how sad their life was, but is interfering with how the brain works the way to get out from it? Is it actually making you happier or is it just a way to stop the brain from rightly feeling bad about how your life is? And how small is the step from going from there to "behavior X is abnormal" or "this thought is abnormal" and attempt to "cure" it in the same way? I'm sure many left-wing idiots would use the same technique to "cure" right-wing idiots and vice-versa if only they could.
Messing with the brain is not only dangerous for the individual, but it is also dangerous for the society at whole. Do we really want to go down this path?
Re:Abnormal brain activity (Score:5, Insightful)
"...whoever experienced it at least once in their life can tell you how sad their life was..."
No, if you listen to them, that's not what they tell you at all.
Real depression has nothing to do with feeling sad, though it may result in continual tears. I don't know quite how to explain it, and its obvious that no-one has ever succeeded in explaining it to you.
It is something quite overwhelming. It is, in visual terms, like wearing glasses that make the view monochrome with a dark grey cast. All color vanishes. People become shadows. When they talk its just words, there is no sense of any real living or feeling person there to interact with. The world has also shrunk so that all you can see is yourself. You look around a familiar room for instance and in some undefinable way it looks strange and alien, and it is the whole world at that moment. You go outside and wonder what on earth you are doing there.
The feeling goes with you wherever you are. You wake up with it, you have it right up to where you fall asleep.
In the beginning this is frightening, and you find ways of trying to manage it. One person I knew, late teens, managed the early stages by reading non stop. Six or more books a day. Anything, history, novels, even books written for much younger people. It was partially successful until the feelings became associated with the books - books forming part of a series were particularly an issue. The account, which may not make any sense, was one of overwhelming dismay that the characters in the series had never really existed.
Someone else I knew went through phases of this. He used to lay in crate of the strongest ale he could buy, and would steadily work his way through it. It felt intolerable while it was happening, but he sort of knew when it had passed.
The later and really dangerous stage of this is when the fear ends. When you are afraid, you are aware of it as a condition and are still fighting. But at some point, you can run out of strength and it has taken over completely. At this point you has become the spectator of your actions. The sense of dread and anxiety has vanished. And it was in this state that the first person I knew took steps which would have ended with suicide. It was described to me as, I did this and this, without having any idea why I was doing it. Then I reversed what I was on the path of, with equally no more idea why.
The next morning this person started to ask for help. But many in the same situation do not.
This has nothing to do with feeling sad. Nothing at all. You may feel sad, but that is a consequence, you can feel sadness and fear about what is happening to you. But the sadness is not what is happening, any more than if you become physically disabled, and feel sad about that. And in the end stage you feel neither sadness nor fear. Your feelings have been burned out.
You can perhaps now see that the implant does not seem so terrible by comparison to the alternative.
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> This has nothing to do with feeling sad. Nothing at all.
It has a great deal to do with sadness. Chronic sadness is one of the primary symptoms of depression. Depression can be horrible, and very difficult indeed to escape, even requiring medical assistance to treat. But to mystify it as being unimaginable to others or divorced from its key symptoms is to ignore the link between mind and body, and to give depression mystical power that _does not help_. And yes, I've had struggles with depression, though
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To say that chronic sadness is one of the primary symptoms of depression is just words. Its like saying that chronic sadness is one of the symptoms of polio.
People with the real thing of depression do feel sad. Rightly so, they are sad and frightened about what is happening to them. At least at first they are. As pointed out above, they run out of feeling eventually, and that is the moment of danger.
You have to imagine lifting some weight in the gym. It feels heavy and you push, and it moves. You keep
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It's more like saying that partial paralysis is one of the symptoms of polio. It's a primary symptom of depression, not an incidental one, and one of the critical factors to treat.
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Depression is (usually) a self-reinforcing chemical cycle in your brain but that doesn't limit self-medication to chemicals. People forget that everything they think and feel is connected to the neural networks and pathways in their brain and relative weights of those connections and efficiencies of those pathways can be manipulated consciously.
Re: Abnormal brain activity (Score:2)
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It is something quite overwhelming. It is, in visual terms, like wearing glasses that make the view monochrome with a dark grey cast. All color vanishes. People become shadows
This is how the patient, Sarah, described the effects of her treatment [wlfi.com]:
For Sarah, the effects were worth the risks. "Any kind of release would have been better than what I was experiencing," she said. "Depression controlled my life. I barely moved. I barely did anything."
The first time the team tried the stimulation after mapping her brain, "I just laughed out loud," Sarah said.
"It was the first time I had spontaneously laughed and smiled where it wasn't faked, it wasn't forced, for five years," she added. "This joyous feeling washed over me."
It took considerable adjustment to make the stimulation feel seamless -- and to make sure the effects lasted for longer than a few minutes.
"At first, within a few weeks, the suicidal thoughts just disappeared. Then it was just a gradual process. It was like my lens on the world changed," Sarah said.
"Everything has gotten easier and easier and easier."
One day sticks in her mind. "I just remember coming home one of the first times the device was on. I could see the bay and where it met the marshes, and I remember being, god -- like, the color differentiation. It's gorgeous -- the light." Sarah's depression symptoms had made the world seem gray and uninteresting.
She's had the implant for a year now, and it's still working for her.
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By "real depression" you are talking about deep clinical depression - I'm not going to argue about different meanings for the word "depression", or if one meaning is more real than the rest, but it's relevant to my point. The fact that clinical depression is very much different from normal feelings of depression resulting from whatever happens in life, like your best friend dying suddenly - which can also affect one for years, but is still normal human reaction which is normally "cured by time" as one proce
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I have very mixed feelings on this.
I suffered severe PTSD throughout my life and also a pretty traumatic family life.
As I'm well on the way of recovery, there's a bunch of what you say that resonate with me. For an easy one, anxiety. I was plagued by anxiety for most of my life. Interestingly... one of my therapists indicated that anxiety is not something to mask; it is often something to listen to. You may not want to actually do something. As I look on my life, I always tried to push down my anxiety to ge
Dumb question (Score:3)
Since this seems to indicate the electrical signals in this person's brain are off, is it possible her voltage is too low or the phases aren't aligned correctly?
No, I'm not trying to be funny. If these electrical impulses have an effect, is it possible depression is the result of the person's electrical impulses not being correct? Or, since some drugs seem to help, there is a lack of interactions between the electrical impulses and the brain chemistry?
Re: Dumb question (Score:3)
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The activity in the brain is electro-chemical. Look up action potential and you'll understand.
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Indeed, I would suggest to check the neurosynaptic confabulator and try to align the phase of the neuronic stream.
Niven (Score:2)
Fuckin' wireheads.
Depression is real (Score:1)
And bad. It seems stupid to have to say that, but apparently it needs to be said based on what some people think.
Effective treatment is necessary, not a bad thing.
I strongly recommend Peter Kramer's book Against Depression to help get an understanding of how real it is and how it works.
We've seen this movie before (Score:2)
Michael Crichton, The Terminal Man.
Just sayin'.
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interesting.
i was thinking the same thing.
i guess michaels work will be tested with this person
Terminal man (Score:2)
Did you watch Terminal Man? Because this is how you get Terminal Man...
Also... (Score:2)
Also, it can help prevent you from accidentally spreading misinformation.
Buttonheads (Score:2)
Stop Trying to fix Depression (Score:1)
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That is exactly what I think. I'm not saying that a certain *small amount* of people are truly and indeed affected by the, let's say, abnormal chemical imbalance in the brain that causes them to feel depressed, but we should start thinking about all the other influences in our society that make people feel depressed. One should also be able to distinguish between the chemical imbalanced depression and just depression because the society we live in is "too demanding" to put it very politely.
The society we li
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Sorry bloke I haven't received any moderation points in weeks for dome reason. Weird. Otherwise I would upvote you. I'm not sure why I haven't received any moderation points in weeks.
I am sure that (Score:1)
I am sure that a surgically implanted brain stimulation device could help treat severe depression, in the same way as placing a candle on your head and setting fire to it could help treat severe depression, but I am curtain there will be side affects of both methods.