Device implanted in the brain to treat severe depression – time.news

by time news
from Daniela Natali

Experiment in the United States on a woman who now claims to feel good. But there are many doubts and the idea of ​​interventions of this type poses all kinds of problems

And if it were possible to treat forms of depression that “resist” drugs (a phenomenon that affects 30% of patients), and do not even respond to electroconvulsive therapy, with a kind of brain pacemaker? A device implanted in the brain that sends impulses capable of “resetting” its functioning? And what’s more capable, just as a pacemaker does to work (in this case not on the heart but on the brain circuits related to depression) only when needed, that is when the symptoms become more severe and suicidal ideas arise?

The experiment

The experiment (because we must speak of an experiment and certainly not a study since it was conducted only on one person), was attempted at the USFC, University of California San Francisco, where a group of researchers implanted a brain device in a 36-year-old woman afflicted for years by a form of severe and incurable depression. The results, according to the same patient, seem excellent. But there are many “buts”.

Limits and uncertainties

Explains Giancarlo Cerveri, director of the Mental Health Department of Lodi: “Devices of this type have been used for years in the treatment of Parkinson’s, epilepsy and, more recently, also in Obsessive Compulsive Disorder, but in these cases they are stimulated , or to inhibit, the activity of brain areas that we well know are intolerance: in the case of depression where to go to act? The brain circuits involved in depression are many and complex. In the aforementioned experiment, s was identified in the amygdala as the site that sends signals such as to “trigger” the alarm and thus induce the implanted device to send “regulatory” electrical impulses to the striatum. Now, we actually know that the amygdala (part of the limbic system, with a fundamental role in emotional responses) plays a role in depression, but is its eventual “malfunction” the cause or the consequence of the disease? In other words: are we sure that the depression originates “there” or is the “source” to be sought elsewhere? The striatum is known for its role in the planning and modulation of movements but it is also known that it is activated by stimuli such as those associated with reward, aversion and, in particular, the “ventral striatum” is connected to the ability to feel pleasure, “zest for life”, often lost in severe forms of depression. This is enough to say that it is precisely in these areas that action must be taken. We are more complex than that. Especially since depression is especially typical of man and one would therefore think it is not linked to “ancient” brain structures of the deep central nervous system such as those mentioned above, but to other “younger”, more “superficial” ones, developed later in the course of evolution localized in the cortex “

The other “physical” methods of treatment

This is certainly not the first time that we think of using “physical” means in the treatment of depression, we already resort to stimulation of the vagus nerve and transcranial magnetic stimulation.
«In the first case – clarifies Cerveri – we resort to a transcutaneous auricular stimulation and we act on this particular nerve because we know that, among other things, it regulates the response to anxiety and stress; in the second case, with a kind of “helmet” equipped with magnets, areas of the deep central nervous system are stimulated. Applied repetitively, magnetic pulses modulate the connections between neurons, known as synapses, and hence brain activity. This technique is also used to address addictions, such as drug and alcohol addictions. Warning: these are not methods capable of replacing “traditional” therapies. Even the white light therapy, especially in northern countries lacking in sunlight, is a “physical” cure and gives good rosulates in seasonal depression “

Invasiveness and risks

The big difference between the latter “physical” therapies and the one attempted now in America is that the former are non-invasive. The device used by the Californian colleagues, on the other hand, provides for a brain implant of electrodes and that of a “control unit” to generate the impulses, positioned under the collarbone. As always in a surgical intervention there are, albeit low, risks of bleeding and infections and then a malfunction of the system can occur, unwanted side effects can occur and, of course, the “control unit” must be replaced periodically. And then there are psychological resistances: it is difficult to accept the idea of ​​having a fixed device implanted in the brain “

Attempts

«This is a“ pioneering ”intervention, it is unthinkable that it will soon be routinely proposed, but it is part of a long line of research for alternative solutions to those already known; it could be thought of as a “lifesaver” in cases where the suicidal risk is high and all other treatments have failed. In any case, attempts of this type can increase our knowledge of the brain and its functioning AND of “depressions” and it is no coincidence that I use the word in the plural »concludes Cladio Mencacci co-president of the Italian Society of Neuropsychopharmacology.

October 5, 2021 (change October 5, 2021 | 13:58)

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