The results of research into the use of new “neural pacemaker” technology published in the journal Nature Medicine are raising hopes some forms of severe depression might in future be successfully treated with brain implants. Doctors researching the technology have seen hugely positive results from clinical tests involving a 36-year-old woman identified as Sarah, who wishes to remain anonymous.
The patient has credited the device, which recognises patterns of electrical brain activity associated with depressive thoughts and then disrupts them through tiny targeted electrical pulses, as returning her “a life worth living”.
Prior to taking part in the groundbreaking trial, Sarah had spent five years struggling with severe treatment-resistant depression. The improvements in her psychological state brought about by the neural pacemaker have now persisted for a year and more patients are now being recruited to extend the trials.
She said of the results of her treatment:
“I felt tortured by suicidal thoughts every day. I was at the end of the line. Now those thoughts still come up, but it’s just . . . poof . . . the cycle stops.”
“When I first received stimulation I felt the most intensely joyous sensation and my depression was a distant nightmare for a moment. I just laughed out loud. It’s the first time I had spontaneously laughed or smiled . . . in five years.”
The research into the new brain implant technology and its use to treat severe forms of depression has been carried out by scientists from the University of California, San Francisco (UCSF). Those involved have hailed the early results experienced by Sarah as a “landmark success” in breakthrough targeted electronics treatments of psychiatric disorders.
Professor Andre Krystal who participated in the research comments:
“This study points the way to a new paradigm that is desperately needed in psychiatry. We’ve developed a precision-medicine approach that has successfully managed our patient’s treatment-resistant depression by identifying and modulating the circuit in her brain that’s uniquely associated with her symptoms.”
There are, however, drawbacks to the new therapy. It involves invasive surgery to place the implant, whose electrodes travel deep into the brain, under the skull. It’s an expensive and risky procedure which means it is only likely to be used as a last resort when severe depression has proven resistant to other treatments. However, as many as 2.7 million people in the UK suffer from treatment-resistant depression.
The neural pacemaker is not a one-size-fits-all technology. The system is tailored to the patient, whose brain activity is monitored for a week while they are regularly asked to describe their mood. Algorithms then identify the electrical activity patterns in the amygdala region of the brain that coincide with a patient’s worst bouts of depression over the period.
The device then applies a small, six-second pulse of electricity to another region of the brain, the ventral stratium, about 300 times a day. The result of these interventions was, the research showed, almost instantaneous in breaking cycles of depressive thoughts as they initiate. Sarah said that these impulses were barely noticeable other than a very slight feeling of heightened alertness.
The system has been adapted from one previously used to treat epilepsy and the implants cost around £26,000. Katherine Scangos, assistant professor of clinical psychiatry at UCSF, who led the research, comments:
“We haven’t been able to do this kind of personalised therapy previously in psychiatry. This success in itself is an incredible advancement in our knowledge of the brain function that underlies mental illness.”
Trials will continue on a further two patients who have already been enrolled with plans for the addition of another nine. However, it is likely that even with further positive outcomes, regulatory approval for the new technology will take several years.