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    Implanted Brain 'Pacemaker' Treats Depression

    Patients Improved With Experimental Implant After Antidepressants Failed
    WebMD Health News

    March 2, 2005 -- A "pacemaker" implanted in the brain appears to help severely depressed patients who don't respond to other treatments.

    In a small but potentially landmark study, four out of six formerly treatment-resistant patients got better after electrodes were implanted in a region of their brains thought to drive depression.

    Electrical stimulation of the brain using a pacemaker-like device was introduced several years ago to help control seizures in patients with epilepsy and help Parkinson's disease patients better control their movements.

    But this is the first time so-called deep-brain stimulation has been used to treat major depression.

    Living a Nightmare

    Debbie (not her real name) is typical of the patients in the study. She tells WebMD that her third bout of depression had lasted eight years when she decided to have the experimental surgery a year and a half ago.

    Her dark moods left her suicidal and unable to function. While antidepressant drugs work for most people with depression, they did nothing to lift Debbie's depression. She says the only thing electroconvulsive "shock" therapy did was wipe out a big part of her memory.

    "I was to the point where I wasn't really planning on living this nightmare too much longer," the 47-year-old Canadian says. "I had been hospitalized repeatedly because I was a danger to myself. I would have tried anything."

    Deep brain stimulation targeted an area of Debbie's brain known as the subgenual cingulated region, or Cg25. In earlier research, Helen Mayberg, MD, showed that Cg25 is overactive in people with treatment-resistant depression.

    In collaboration with Andres Lozano, MD, who is a leading expert on deep-brain stimulation, Mayberg and colleagues theorized that sustained electrical jolts could normalize the targeted region and make the entire brain behave more normally.

    How It's Done

    Two holes, the size of nickels, were drilled into the skulls of the patients who remained awake. The area of the surgery was numbed with anesthetic. Using magnetic imaging to guide them, surgeons then implanted two thin wires with electrode contacts near the Cg25 area of the patients' brains. The loose end of the wires were then threaded under the skin and attached to the pacemaker device, which was implanted in the chest.

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