MONDAY, Jan. 2 (HealthDay News) -- A small study suggests that
deep brain stimulation, which is currently being investigated as a
treatment for general depression, may also help patients with
bipolar disorder.
There are some caveats. The surgery necessary to allow deep
brain stimulation is extremely expensive. And for now, the research
is preliminary, so it's too early to know for sure if the treatment
is appropriate to be used for any kind of depression.
Still, the study suggests that brain stimulation "not only just
helps patients who haven't been able to recover from depression,
but it seems to be associated with the absence of relapses. They're
not only getting better, they're staying better," said study
co-author Dr. Helen Mayberg, a professor in both the departments of
psychiatry and behavioral sciences, and neurology, at Emory
University School of Medicine in Atlanta.
In deep brain stimulation, surgeons insert wires into the brain
that allows a specific region to be continuously hit with an
electronic pulse. The level of stimulation is controlled by a
pacemaker-like device implanted in the chest.
Deep brain stimulation has been around for more than 20 years,
Mayberg said, and is commonly used to treat Parkinson's disease.
The cost of the surgery is about $50,000, she said.
Previous research by Mayberg and others suggested that deep
brain stimulation had potential as a treatment for depression. The
St. Jude Medical Neuromodulation company, which has provided
consulting fees to Mayberg and some of the other study authors, is
currently recruiting patients for a study that could pave the way
for its approval as a treatment for depression, Mayberg said.
The new study, which appears online Jan. 2 in the
Archives of General Psychiatry, began with 10 patients with depression and seven with bipolar disorder -- a condition that causes severe mood swings and is also known as manic depression. They all received deep brain stimulation for 24 weeks after going through four weeks either with or without stimulation.
Most of the patients continued to receive the treatment over two
years, although researchers temporarily turned it off in three of
them as part of the study before realizing that doing so caused
their depression to return.
The researchers found that 18 percent of patients went into
remission after 24 weeks, 36 percent (of 14 patients) after one
year. After two years, of the 12 patients still in the study, seven
patients (58 percent) were in remission.
"The number of patients who got better increased over time, but it's not quite clear as to why," Mayberg said. The workings of deep brain stimulation as a whole are a mystery, although Mayberg said it may work by changing the brain's rhythms.
Patients didn't suffer from side effects, she noted.
So, what's next?
Dr. Samuel James Collier, an assistant professor of psychiatry
at the University of Texas Southwestern Medical Center at Austin,
predicted that even if deep brain stimulation turns out to be an
effective treatment for depression, it'll be far from the first
line of defense.
"Medications and ECT -- electroconvulsive therapy -- are clearly safer, better tolerated, and do not embody a large surgical risk," Collier said. "I can't think of a scenario where deep brain stimulation would be considered even remotely before medications and ECT were exhausted."
Still, he said, it's important to note that "we seem to be
making progress and hopefully those who are suffering the most can
find solace in that and not give up hope."
For now, research continues. If patients are interested in deep
brain stimulation treatment, they should try to get into the study
that's ongoing, Mayberg said.
More information
For more about
deep brain stimulation, visit the U.S. National Library of Medicine.