More than 16 million people are affected by major depressive disorders each year in the United States. Worldwide, depression is the leading cause of disability. Moreover, approximately one-third of the people suffering from major depressive disorders are unable to find relief from existing treatments.
Recently, a new technique has received a great deal of attention as a possible solution for people suffering from severe, intractable depression. This new technique is known as deep brain stimulation.
Deep brain stimulation involves surgically implanting electrodes in the brain in order to send electrical currents to specifically targeted areas. A team of researchers from the University of California San Francisco, led by Dr. Eddie Chang, a professor of neurosurgery at UCSF, studied the effects of deep brain stimulation on people suffering from depression. The results were published in the journal Current Biology.
Dr. Chang and his colleagues explained that they focused on the orbital frontal cortex, one of the least understood regions of the brain, since it is highly connected to brain structures linked to both mood and decision-making. They pointed out that these facts make the orbital frontal cortex a natural place for the interaction between emotion and cognition.
Since the concept of implanting electrodes in the brains of people in order to test deep brain stimulation was impractical, Dr. Chang and his colleagues recruited participants with depression who were also suffering from a drug-resistant form of epilepsy that was being managed with brain stimulation. These people already had electrodes in place, no special surgery was required.
The research team designed a special app to allow participants to report how they were feeling throughout the day. This allowed the researchers to connect changes in brain activity with changes in mood, while focusing on the brain area of interest: the orbital frontal cortex.
At the end of the study, a careful analysis of the data was performed. The analysis revealed that stimulation of the orbital frontal cortex led to significant improvements in the participants’ level of depression. It also revealed that stimulation of other parts of the brain had no effect on the participants’ levels of depression.
It was also noted that individuals with more severe depression benefited the most from deep brain stimulation. People with mild depression saw almost no benefit whatsoever from this technique.
The patients themselves were well aware of the effect that deep brain stimulation was having on them, and reported feeling less anxious and much more relaxed.
It was also noted that the participants’ body language demonstrated that the deep brain stimulation was having a positive effect on them: they smiled more, they sat straighter, and they spoke in a more natural manner. From an objective point of view, brain activity patterns supported the improvements mentioned above.
The new research adds weight to previous studies that showed that orbital frontal cortex activity becomes elevated in patients with severe depression. What this research added is that electrical stimulation of this region helps to eliminate this elevated activity, allowing positive mood to occur in otherwise depressed people.
The main focus of further research will be to determine the long-term effects of this technique. Nevertheless, for those who are suffering from severe, intractable depression, it is good news to hear that a solution may finally be at hand.
Elderly people, in particular, are at high risk for depression. The many losses they have faced; the constantly changing quality of their lives, particularly the diminishment of their independence and ability to participate in activities they used to enjoy, put the elderly population at high risk for depression.
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