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    Implanted Brain 'Pacemaker' Treats Depression

    Patients Improved With Experimental Implant After Antidepressants Failed

    How It's Done continued...

    All six of the patients reported improvement soon after the surgery. Two of the six became depressed again within six months.

    The four other patients had few depression symptoms six months after surgery, and all still have the implants. Imaging studies revealed brain changes consistent with a return to normal Cg25 activity. These changes have also been seen in depressed patients who respond well to drug treatment.

    The findings are reported in the March 3 issue of the journal Neuron.

    Mayberg says the findings could represent the first step in a paradigm shift in the thinking about depression. Drug treatments target chemical imbalances within the brain. But the early research indicates that for some patients successful treatment will require "rewiring" parts of the brain's circuitry.

    "This study tells us that this strategy has real potential … that our first target [within the brain] looks like it was a good selection," she says. "It may be that there are other areas of the brain that are better, but that remains to be determined."

    Return to Normal

    One of the big advantages of the brain pacemaker is that the electrical impulses can be adjusted in patients who don't respond as hoped. Debbie says it took about a year of tweaking, but she now feels "perfectly normal" for the first time in almost a decade.

    Unable to do much more than stare out her bedroom window for hours at a time before the surgery, she is now planning to open her own business.

    "Unlike the drugs that have failed me, I feel like if, God forbid, this stops working they can make adjustments to get me back on the right track," she says.

    All agree that more study is needed to confirm the findings, and that, as with Parkinson's disease, only the sickest patients who don't respond to other treatments would be candidates for the procedure.

    "Even brain surgery that is relatively benign, as this is, is a serious procedure," Mayberg says.

    "You don't operate on someone's brain if there are other reasonable treatment options. But this is also a serious disease that leaves people morbidly sick for long periods of time. When you see these people living normal lives the way other people do, it is both sobering and humbling," she explains.

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