Scientists treat severe depression with 'pacemaker for the brain'

Scientists have successfully treated a patient with severe depression by using a ‘pacemaker for the brain’, according to a new study.

Using a surgically implanted device, they tapped into the specific brain circuit involved in depressive brain patterns and reset them using the instrument.

Researchers say the proof-of-concept study reveals how brain activity may be used to deliver personalised treatment for neuropsychiatric disorders.

Andrew Krystal, professor of psychiatry and member of the University of California San Francisco Weill Institute for Neurosciences, said: ‘This study points the way to a new paradigm that is desperately needed in psychiatry.

‘We’ve developed a precision-medicine approach that has successfully managed our patient’s treatment-resistant depression by identifying and modulating the circuit in her brain that’s uniquely associated with her symptoms.’

Previous studies have shown limited success for treating depression with traditional deep brain stimulation (DBS).

Researchers suggest this is partly because most devices can only deliver constant electrical stimulation, usually only in one area of the brain.

However, what made the new trial successful was the discovery of a neural biomarker – a specific pattern of brain activity that indicates the onset of symptoms.

The team customised a new DBS device to respond only when it recognised that pattern.

The device then stimulates a different area of the brain circuit, creating on-demand, immediate therapy that is unique to both the patient’s brain and the neural circuit causing their illness.

First author Katherine Scangos, member of the Weill Institute, said: ‘We were able to deliver this customised treatment to a patient with depression, and it alleviated her symptoms.

‘We haven’t been able to do this kind of personalised therapy previously in psychiatry.’

Prof Krystal said the immediate effect was in contrast to the four to eight-week delay of standard treatment models.

It has also lasted over the 15 months that the patient, who asked to be known by her first name, Sarah, has had the implanted device.

For patients with long-term, treatment-resistant depression, that result could be transformative, researchers said.

The scientists say further research will be needed to determine if these results are generalisable to a broader population.

The study is published in Nature Medicine.

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