Hope for people with treatment resistant Major Depression

from JoeUser Forums

 

Many folks have asked for “medical stuff” (enough computer viruses how about human ones?) so, this is about some gadgetry which has caused an earthquake in the treatment of depression.

Many folks have episodes of Depression through their lives, tied to events or not. In most, they resolve without the need for intervention. In many though, medications (thank G-d for them) are needed (and they work well for most, Mr. Cruise). They aren’t uniformly successful, and can cause problems (occasionally severe). They often need change, and for those in whom they failed, or caused other problems only behavioral therapy or ECT (electro-convulsive shock) remained as possibilities.

Now there’s something new: DBS (Deep Brain Stimulation). This form of therapy was initially found for movement disorders (Parkinson’s disease, and the like), and experimentally for anti-pain treatment.

In this form of treatment, electrodes are placed by a Neurosurgical team in problem areas. These devices work very similarly to heart pace makers: There’s a battery and miniprocessor (externally programmable) and electrodes (single or double) on wires placed beyond the problem area of electrical blockage. Some of these devices also function as defibrillators.

So, what does it look like?

Just like that.

Where does it go? In Brodmann Area 25 which is a sort of “conduit” of fibers going from the frontal lobe to the limbic area (regular and in 3D from the Wikipedia):

 

 

Graphically:

 

And in real life:

 

So, the patient is mildly sedated during the procedure and as electrodes are stimulated, describes his/her feelings. Various electrodes along the wire are stimulated until a helpful one is found. The generator is then programmed and placed under the skin (just like a pacemaker) and wires run under the skin to a connection point (in the xray, the four horizontal bars).

So…. As requested… some medical stuff.

Sources:

https://en.wikipedia.org/wiki/Brodmann_area_25

http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=12999&cn=5

http://psychcentral.com/blog/archives/2006/10/11/area-25-may-help-the-severely-depressed/http://www.medicalnewstoday.com/releases/106460.php

http://www.empowher.com/depression/content/depression-and-brodmann-area-25

http://psychcentral.com/news/2008/06/27/new-study-of-dbs-for-depression/2518.html

106,623 views 46 replies
Reply #1 from WinCustomize Forums Top

Would this help people diagnosed as bi-polar Doc? I have a couple of friends who could use it is it does.

Reply #2 from WinCustomize Forums Top

I'm not aware of its use in bipolarity, Tom... if it were only to stop Depression but not hypomania, might not be good... 

One thing for sure: We're only at the beginning - "walking along the seashore, pausing to pick up a pretty shell here and there, while the whole ocean lies before us."

Sins of a Solar Empire: Rebellion
Reply #3 from WinCustomize Forums Top

Interesting stuff.

Reply #4 from WinCustomize Forums Top

i find with my bipolar... when im depressed, andy takes me outside for a stroll around our town... works wonders..

plus i hate being stuck indoors 24/7 its not healthy for anyone...

Reply #5 from WinCustomize Forums Top

Correct... exercise is a very good addition for many reasons, not just how it helps depression. Good addition to the post, Vamps - thanks. :)

Reply #6 from Stardock Forums Top

I wouldn't trust DBS any more than I do pacemakers.  Obviously they can be necessary, but enough of em screw up to make you worry.

Mind you it sounds like a great idea, just a tiny bit dangerous.

Reply #7 from WinCustomize Forums Top

Yeah. Suicide's much better.

Note: Only if drugs and all other dangerous treatments fail.

 

 

Reply #8 from WinCustomize Forums Top

Dr. JBHL....

It looks very much like the VNS... The Vagus Nerve Stimulator... used for Epilepsy. Think of it as a pacemaker for the brain. It sends electrical signals every so often through the left Vagus Nerve to the brain to try an prevent seizure activity. I will be having surgery soon to replace it since it's battery life just went out of service.

I also have MS. Anti Depressants are being taken to help control the temper that can come with Epilepsy. Can this device interfere with the Vagus Nerve Stimulator? :meow:

Reply #9 from Stardock Forums Top

Quoting DrJBHL, reply 8
Yeah. Suicide's much better.

Note: Only if drugs and all other dangerous treatments fail.
End of DrJBHL's quote

What other dangerous treatments?  Beating em with a stick?   :|

 

Anyway, I'd personally love to have something like this though I'm not suicidal.  Just not sure I couldn't find a better way.

Reply #10 from WinCustomize Forums Top

These electronic implants may be a great advance in technology but I have to ask, quite seriously;

If microwaves in public locations can have bad effects on pacemakers, enough so to require warnings, how safe are implanted devices in the brain?

Reply #11 from WinCustomize Forums Top

Micowaves are dangerous only if unshielded... i.e. cooking with an open door (which can't be done, anyway). In the public, there is no real danger at ll. Just don't stand in front of a jet or radar set when it's on, or in a strong magnetic field (like an MRI).

As I wrote. This IS NOT a "first line" option. Meds, behavioral therapy are. If they fail? I'd rather have the implant than ECT, any day.

Why is it pacemakers are safe, but these devices which act in the same way are not?

Reply #12 from WinCustomize Forums Top

Quoting TheCatsMeowMix, reply 8
Dr. JBHL....

It looks very much like the VNS... The Vagus Nerve Stimulator... used for Epilepsy. Think of it as a pacemaker for the brain. It sends electrical signals every so often through the left Vagus Nerve to the brain to try an prevent seizure activity. I will be having surgery soon to replace it since it's battery life just went out of service.

I also have MS. Anti Depressants are being taken to help control the temper that can come with Epilepsy. Can this device interfere with the Vagus Nerve Stimulator?
End of TheCatsMeowMix's quote

From the OP...

In this form of treatment, electrodes are placed by a Neurosurgical team in problem areas. These devices work very similarly to heart pace makers: There’s a battery and miniprocessor (externally programmable) and electrodes (single or double) on wires placed beyond the problem area of electrical blockage. Some of these devices also function as defibrillators.
End of quote

I don't believe they would interfere with each other, TCMM - theoretically... quite distant from each other and the stimuli are very small in output. I don't know of any article about that possibility. BTW... only the "generator/battery" will be changed, not the wires. They'll be left in place.

Reply #13 from WinCustomize Forums Top

I get depressed on occasion ,  and so my heart really goes out to those who suffer this.

 

What helps me is actually what Vamps mentioned-  getting outside.    I'm lucky to live near some park areas, and even in our suburbs, there are a few trees-  just getting out into the sunlight with some greenery and birds around really uplifts me.

During the Winter months, I need to use those SADD sunlamps-- which do make a difference as well.   It gets dark here, in the Northeastern regions of the US.   

What also helps me during my depression times is making sure I get enough essential oils--  especially Oil of Evening Primrose which I found effective in stabilizing my PMS bouts.       Essential Oils are also great for those suffering Bipolar--    which  my aunt - a very intelligent woman - suffers, so I also feel deeply for anyone going through that as well.

 

Reply #14 from WinCustomize Forums Top

Dr. JBHL...

I forgot to mention... a person with the Vagus Nerve Stimulator cannot go through metal detectors... be around strong magnetic fields or have an MRI. The VNS can be controlled through a magnet to turn it on if a person feels a seizure is coming on if the VNS is not currently going through its cycle. They can turn it off by taping the magnet to their chests too if they have to for any reason. Is this device also controlled by a magnet?

Reply #15 from Elemental Forums Top

read chricton's book called terminal man?

Reply #16 from JoeUser Forums Top

So, the patient is mildly sedated during the procedure and as electrodes are stimulated, describes his/her feelings. Various electrodes along the wire are stimulated until a helpful one is found. The generator is then programmed and placed under the skin
End of quote

Sounds disturbing, it doesn't fix an actual problem but uses direct manipulation of emotions to mask symptoms.

It is calibrated to force "positive" emotional states via direct brain cell stimulation with gross electrical signals (neurons transmit on a cell to cell basis), in effect faking electrical impulses from other parts of the brain to fake emotions.

I also cannot see it being effective since the brain is constantly re-calibrating and such repeated stimulation will cause the area to lose sensitivity until the new baseline requires this stimulation.

Also, electromagnetic radiation such as microwave turns into electricity when it hits metal. Shielding against that can only be achieved via a Faraday cage and grounding. This will ground into the brain of the patient which is bad. And what if the electrodes move? (very bad!)

Reply #17 from WinCustomize Forums Top

Quoting TheCatsMeowMix, reply 14
Dr. JBHL...

I forgot to mention... a person with the Vagus Nerve Stimulator cannot go through metal detectors... be around strong magnetic fields or have an MRI. The VNS can be controlled through a magnet to turn it on if a person feels a seizure is coming on if the VNS is not currently going through its cycle. They can turn it off by taping the magnet to their chests too if they have to for any reason. Is this device also controlled by a magnet?
End of TheCatsMeowMix's quote

Yes it is programmed (like pacemakers) with a unit employing magnets.

Quoting taltamir, reply 16
Sounds disturbing, it doesn't fix an actual problem but uses direct manipulation of emotions to mask symptoms.

It is calibrated to force "positive" emotional states via direct brain cell stimulation with gross electrical signals (neurons transmit on a cell to cell basis), in effect faking electrical impulses from other parts of the brain to fake emotions.

I also cannot see it being effective since the brain is constantly re-calibrating and such repeated stimulation will cause the area to lose sensitivity until the new baseline requires this stimulation.

Also, electromagnetic radiation such as microwave turns in electricity when it hits metal. Shielding against that can only be achieved via a Faraday cage and grounding. This will ground into the brain of the patient which is bad. And what if the electrodes move? (very bad!)
End of taltamir's quote

1. It changes the brain chemistry using electricity - just like the brain (and any tissue which maintains a potential difference does).

2. It does not "force" anything. Depression "forces" problems. The patient isn't turned into a grinning idiot.

3. About EMR? If strong enough, it will cook anyone with or without a medical device.

 

Reply #18 from Sins Forums Top

There is a HUGE amount of research driving this sort of invention that has NEVER been seen before.

The research focus for the past few years on Alzheimer's, Parkinsons, Creutzfeldt–Jakob's Disease, ADD/AAHD as well as depression studies, endocrinology and even the fields of artificial intelligence, neural sciences and cybernetics have synergistically started to dovetail together and are providing huge amounts of very precise data on how the brain and nervous system work.

It is the first time we have ever had the technological tools to actually map and experiment real-time with the brains multifaceted processes--electromagnetic, hormonal, etc.--while it is working.

This isn't like the days when we used tap hammers to drive metal rods into people's brains to see if it might help.  We can now watch in real time the molecular, chemical and physical changes happening in the brain as we interact with it.  The understanding of the brain is greater than it has ever been in history and this may be one of those watershed moments where whole new realms of treatment and cure become available.

Depression is one of the biggest issues because it affects everyone in the world and there are so many areas affected by it and causal to it that a lot of information and research is needed.  If you have ever known anyone "chemically lobotomized" as the means of managing their symptoms, you'd understand why any sort of experiment that might give hope is worth it to a lot of people.

They recently just lab demonstrated a machine that allowed to computer wired couples to ask and answer each other's questions without saying a word and in future plan to do trials with comatose and brain dead patients to see if they are capable of "yes-no" conversations.

I have a friend who was just prescribed Abilify and for her it works wonders--she said the "cloud is gone" and she feels perfectly normal...yet the adverse effects for people who don't respond well to the drug are frightening.  We need a lot more alternatives.

Reply #19 from WinCustomize Forums Top

Precisely, Sinperium.  :thumbsup:

Reply #20 from Sins Forums Top

One thing's for sure, medical science is advancing into areas long thought way past science fiction. 

Personally, I am taking drugs manufactured on a molecular level. We have video and audio signals that can be sent directly into the brain (hearing impaired, blind, etc). With the increased mapping of the brain, the above is becoming not only possible, but approaches the mundane.

The future is amazing. And a little frightening. And it's nearly here, too. :)

On another note, this is one area I'd personally move into veeeery carefully. I'd be curious to know what the long term effects of sending impulses directly into the brain this way would be; would it affect emotional or mental development in any way? Would the lack of an internal cause/effect link cause 'confusion' in the development of responses? (This is very much in layman's terms.). 

 

 

Reply #21 from WinCustomize Forums Top

I read in some article a few months ago, they're trying this (DBS) for PTSD.  The patient still remembers the traumatic event, but they remember it as if they were watching it in a movie to an actor (detached) rather than actually reliving the traumatic event over again themselves.  This is fantastic news.

Reply #22 from WinCustomize Forums Top

Quoting k10w3, reply 21
I read in some article a few months ago, they're trying this (DBS) for PTSD.  The patient still remembers the traumatic event, but they remember it as if they were watching it in a movie to an actor (detached) rather than actually reliving the traumatic event over again themselves.  This is fantastic news.
End of k10w3's quote

That would seem to be the behavioral method as well, Karen... using video game simulation loosely, then more and more closely to reproduce the original event and by doing so 'desensitize' (much like allergy shots) the person to the original trauma.

Quoting Khardis, reply 20
I'd be curious to know what the long term effects of sending impulses directly into the brain this way would be; would it affect emotional or mental development in any way? Would the lack of an internal cause/effect link cause 'confusion' in the development of responses?
End of Khardis's quote

For long range results, we'll just have to wait. Lack of an 'internal link'? I'm afraid I don't understand what you're trying to convey there.

Reply #23 from Sins Forums Top

Quoting DrJBHL, reply 12
Micowaves are dangerous only if unshielded... i.e. cooking with an open door (which can't be done, anyway).
End of DrJBHL's quote

Why can't that be done? Maybe not in a perfectly functional modern microwave, but it's certainly possible and I've seen one that insisted on staying on if you opened the door.

Reply #24 from WinCustomize Forums Top

Only 'problem' is that some of the world's most 'creative' minds have been depressed and/or suicidal, etc.  'Kill' the 'disease' and bang goes their creative artistry.

Simple test....see if you can list ALL of the British comedians who WEREN'T cronically depressed and/or suicidal....;)

 

Then there's all those musicians that have taken themselves 'out' with illicit and/or prescription drugs.....

Reply #25 from WinCustomize Forums Top

Quoting LightStar, reply 1
Would this help people diagnosed as bi-polar Doc? I have a couple of friends who could use it is it does.
End of LightStar's quote

 

Was my question too. At least they are admitting that depression exists.