UCSF’s Personalized Brain Pacemaker Treats Severe Depression Successfully

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Neuromodulation, where a device emits electrical impulses to stimulate parts of the brain in the hope of regulating damaged signals related to conditions such as anxiety, depression, Parkinson’s disease, etc., has been successful in providing relief. symptoms of these conditions.

This success has been limited, however, by the fact that many neurological diseases present themselves differently from person to person, which minimizes the potential effects of standardized and “one size fits all” deep brain stimulation devices, especially for patients. difficult to deal with. conditions like depression.

But here is the exception that proves the rule: when a new neuromodulation device developed by researchers at UCSF Health was personalized according to a patient’s specific brain patterns, it demonstrated almost immediate success in relieving his pain. severe, treatment-resistant depression, according to a to study published Monday in Nature Medicine.

Their stimulation system includes a small device implanted in the patient’s brain that constantly monitors neurological activity and orders two leads in separate areas of the brain to emit electrical impulses if abnormal activity is detected. The system, which researchers call a “brain stimulator,” had previously been successful in treating epilepsy.

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Treatment for the patient, identified by her first name, Sarah, began with an analysis of her brain electrical activity. The researchers mapped out patterns in this activity that matched mood swings, noting where the signals came from, resulting in a map of his “depression circuit” that could be used as a neural biomarker linking symptoms of depression. from Sarah to specific patterns. in his brain signals.

The biomarker was then used to program the stimulation device, which is trained to trigger the six-second regional pulses only when a specified pattern occurs.

The treatment relieved Sarah’s symptoms of depression almost immediately, the researchers said, and those improvements have lasted for about 15 months since she was implanted with the device last summer. This is in stark contrast to other deep brain stimulation devices, which typically offer relief from symptoms of depression four to eight weeks after starting treatment, despite continued stimulation throughout this time.

“The idea that we can treat symptoms in the moment, as they arise, is a whole new way to deal with the most difficult to treat cases of depression.” noted Katherine Scangos, MD, Ph.D., assistant professor of psychiatry at the University of California, San Francisco and first author of the study.

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To continue validating the technology as a treatment for severe depression, the researchers recruited two more patients into the trial, with the intention of eventually reaching a group of 12.

“We have to look at how these circuits vary from patient to patient and repeat this work several times. And we need to see if an individual’s biomarker or brain circuitry changes over time as treatment continues, ”Scangos said.

Yet success with a single patient has already proven the technology’s potential both for treating depression and for mapping neurological patterns and signals, a process that has largely stalled the field of medicine.

“The effectiveness of this therapy showed that not only did we identify the right brain circuit and the right biomarker, but we were able to replicate it at an entirely different later phase of the trial using the implanted device,” Scangos explained. “This success in itself is an incredible advance in our understanding of the brain function that underlies mental illness.”


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